| Item No. | 1 |
|---|---|
| Lender's Name | CHARLES B SULLIVAN |
| Lender's Title | PRESIDENT |
| Original Amount of Loan | 850 |
| Balance Due | 850 |
| Date of Note | 2011-04 |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | FORM 1023 APPLICATION FEE |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 2 |
|---|---|
| Lender's Name | CHARLES B SULLIVAN |
| Lender's Title | PRESIDENT |
| Original Amount of Loan | 500 |
| Balance Due | 800 |
| Date of Note | 2011-12 |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | PROVIDE FUNDS |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LETTER OF DETERMINATION FEE | 400 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ANALYSIS OF TAX ISSUE | 300 | 0 | 0 | 0 |