| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| HSBC ANNUITY | AT COST | 1,396,526 | 1,396,526 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEES | 10 | 0 | 0 | 0 |
| Name | Address |
|---|---|
| JACOB KEMPLER |
1638 47TH STREET BROOKLYN,NY11219 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| IRS | 55 | 0 | 0 | 0 |
| IRS 2013 | 1,500 | 0 | 0 | 0 |
| NYS | 25 | 0 | 0 | 0 |