| Identifier | Return Reference | Explanation |
|---|
| Item No. | 1 |
|---|---|
| Lender's Name | Laura Rothacker |
| Lender's Title | President |
| Original Amount of Loan | 15000 |
| Balance Due | 15000 |
| Date of Note | 2012-12 |
| Maturity Date | 2013-12 |
| Repayment Terms | Annually |
| Interest Rate | |
| Security Provided by Borrower | None |
| Purpose of Loan | Charitable Purpose |
| Description of Lender Consideration | |
| Consideration FMV | 15000 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Administrative Fees | 6,480 | 6,480 | ||
| State or Local Filing Fees | 10 | 10 |