| Identifier | Return Reference | Explanation |
|---|
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| PACIFIC LIFE - POLICY VF51918560 | 1,730,755 | 1,350,151 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Administrative Fees | 6,653 | 6,653 | ||
| Premium Payment for Foundation-owned Life Ins. | 405,183 | |||
| State or Local Filing Fees | 25 | 25 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Estimated Tax for 2012 | 9,300 | |||
| IRS Excise Tax Payment with 1st ext 990-PF | 9,667 |