| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEE | 1,000 | 0 | 0 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990-PF PAGE 1 LINE 10 | THIS AMOUNT REPRESENTS A THEFT LOSS FROM AN INVESTMENT IN 221,666BERNARD L MADOFF INVESTMENT SECURITIES. IN 2008, WHEN THE THEFT LOSS WAS ORIGINALY UNCOVERED,AN AMOUNT OF THE QUALIFIED INVESTMENT WAS DEDUCTED PURSUANT TO REV. PROC.2009-20. IN THE CURRENT YEAR, THE REMAINING AMOUNT OF THEINVESTMENT, NOT PREVIOUSLY DEDUCTED, IS BEING DEDUCTED, ASTHIS IS THE YEAR IT WAS FINANCILY DETERMINED THAT THERE IS NO FURTHER CHANCE OF RECOVERY. SHAPIRO HILL CLASS ACTION SETTLEMENT-REIMBURSEMENT FOR THEFT LOSS -2,488TOTAL THEFT LOSS DEDUCTION 219,178 | |
| FORM 990-PF | DISCLOSURE REGARDING 2014 FORM 1099-DIV RECEIVED FROMBERNARD L. MADOFF INVESTMENT SECURITIES LLC================================================THE TAXPAYER RECEIVED A 2014 FORM 1099-DIV FROM BERNARD L.MADOFF INVESTMENT SECURITIES LLC ("BLMIS") REPORTING IN BOX3 A NON-DIVIDEND DISTRIBUTION IN THE AMOUNT OF$200,000. THIS FORM WAS ISSUED IN ERROR AS THETAXPAYER DID NOT RECEIVE ANY MONEY OR OTHER PROPERTY FROMBLMIS. THEREFORE, THE TAXPAYER HAS NO REPORTING REQUIREMENTAS IT RELATES TO THIS FORM 1099-DIV. THE TAXPAYER ATTEMPTEDTO HAVE THE FORM 1099-DIV RESCINDED AND/OR CORRECTED, BUTWAS NOT SUCCESSFUL.` |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| SIPIC CLAIM RECEIVABLE | 221,666 | 0 | 0 |