| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| HUGHES, SNELL & CO., P.A. | 775 | 675 | 100 |
| Person Name | Explanation |
|---|---|
| MARY JO DERNBACH |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| POLARIS PLATINUM III VARIBL ANNUITY | FMV | 127,774 | 127,774 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| POSTAGE | 49 | 49 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| ANNUITY GAIN | 20,437 | 20,437 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXCISE TAX | 236 |