| Lender's Name | Lender's Address | Amount Borrowed | Use of Borrowed Funds | Election Statement |
|---|
| Person Name | Explanation |
|---|
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| Computer | 649 | 338 | 311 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| BUSINESS EXPENSES | 14,416 | 14,416 |