| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEES | 1,400 | 0 | 1,400 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE POLICY | FMV | 229,811 | 317,879 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| 2012 MN FILING FEE | 25 | 0 | 25 | |
| LIFE INSURANCE PREMIUM PAID ON CONTRACT WITH INSURABLE INTEREST | 49,683 | 0 | 0 |