| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING | 10,000 | 10,000 |
| Description of Amortized Expenses | Date Acquired, Completed, or Expended | Amount Amortized | Deduction for Prior Years | Amortization Method | Current Year Amortization | Net Investment Income | Adjusted Net Income | Total Amount of Amortization |
|---|---|---|---|---|---|---|---|---|
| AMORTIZATION - ORGANIZATION | 3,951 | 3,951 | 3,951 | 7,902 |
| Person Name | Explanation |
|---|---|
| KATHLEEN HARRIS | |
| PETER FARNSWORTH | |
| SHAWN HARRIS | |
| LYNN HALL | |
| ZAN HARRIS | |
| LITA BLANCHARD | |
| SHARON FARNSWORTH | |
| CLINTON PHILLIPS | |
| KATHERINE PHILLIPS |
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|---|---|---|---|---|---|---|---|---|
| DEPRECIATION - BLDG & IMPROVE | 72,019 | 76,679 | 76,679 | ||||||
| DEPRECIATION - LAND IMPROVEMEN | 5,351 | 6,446 | 6,446 | ||||||
| DEPRECIATION 10 YR EQUIPMENT | 9,852 | 11,296 | 11,296 | ||||||
| DEPRECIATION - EQUIPMENT | 86 | 255 | 255 | ||||||
| DEPRECIATION MOTOR VEHICLES | 6,474 | 7,445 | 7,445 | ||||||
| DEPRECIATION MOTOR VEHICLE | 743 | 2,805 | 2,805 | ||||||
| DEPRECIATION LEASEHOLD IMPROV | 23,174 | 23,094 | 23,094 | ||||||
| DEPRECIATION LEASEHOLD IMP | 200 | 200 | 200 |
| Name | Date Acquired | How Acquired | Date Sold | Purchaser Name | Gross Sales Price | Basis | Basis Method | Sales Expenses | Total (net) | Accumulated Depreciation |
|---|---|---|---|---|---|---|---|---|---|---|
| TV | 2003-05 | PURCHASE | 2014-05 | 196 | 196 | |||||
| WASHING MACHINE | 2005-12 | PURCHASE | 2013-10 | 471 | -106 | 365 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| LAND IMPROVEMENTS | 52,114 | 11,798 | 40,316 | 40,316 |
| BUILDING & IMPROVEMENT | 1,729,790 | 148,698 | 1,581,092 | 1,581,092 |
| EQUIPMENT MAJOR MOVEABLE | 145,994 | 84,325 | 61,669 | 61,669 |
| EQUIP. MAJOR MOVEABLE 10 Y | 2,137 | 349 | 1,788 | 1,788 |
| EQUIPMENT MOTOR VEHICLES | 102,293 | 66,740 | 35,553 | 35,553 |
| LEASEHOLD IMPROVEMENTS | 332,041 | 97,862 | 234,179 | 234,179 |
| LEASEHOLD IMPROVEMENTS | 3,172 | 998 | 2,174 | 2,174 |
| COMPUTER EQUIPMENT | 10,596 | 10,160 | 436 | 436 |
| CONSTRUCTION WORK IN PROGRESS | 17,000 | 17,000 | 17,000 | |
| LAND | 105,992 | 105,992 | 105,992 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ADMIN - LEGAL FEES | 39 | 39 |
| Item No. | 1 |
|---|---|
| Lender's Name | ANDROSCOGGIN BANK |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 14450 |
| Balance Due | 10011 |
| Date of Note | 2012-11 |
| Maturity Date | 2017-11 |
| Repayment Terms | MONTHLY P&I |
| Interest Rate | 0.0500 |
| Security Provided by Borrower | VEHICLE |
| Purpose of Loan | PURCHASE VEHICLE |
| Description of Lender Consideration | |
| Consideration FMV |
| Item No. | 2 |
|---|---|
| Lender's Name | ANDROSCOGGIN BANK |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | 24000 |
| Balance Due | 15859 |
| Date of Note | 2012-09 |
| Maturity Date | 2017-10 |
| Repayment Terms | MONTHLY P&I |
| Interest Rate | 0.0500 |
| Security Provided by Borrower | VEHICLE |
| Purpose of Loan | PURCHASE VEHICLE |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| ORGANIZATION COSTS | 37,555 | 33,354 | 33,354 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| ACTIVITIES PROGRAM | 8,182 | 8,182 | ||
| ADMIN - DATA PROCESSING FEES | 100,000 | 100,000 | ||
| BANK AND LATE FEES | 325 | 325 | ||
| DUES AND SUBSCRIPTIONS | 3,006 | 3,006 | ||
| EMPLOYEE RECRUITMENT AND RETE | 4,849 | 4,849 | ||
| FOOD AND DIETARY SUPPLIES | 38,316 | 38,316 | ||
| HOUSEKEEPING | 3,544 | 3,544 | ||
| INSURANCE | 58,295 | 58,295 | ||
| MARKETING AND PROMOTIONS | 4,932 | 4,932 | ||
| MEDICAL AND OPERATING SUPPLIE | 126,341 | 126,341 | ||
| NURSING AND PHARMACY | 5,726 | 5,726 | ||
| OFFICE EXPENSE | 20,030 | 20,030 | ||
| PAYROLL SERVICE FEES | 4,221 | 4,221 | ||
| PROVIS FOR DOUBTFUL ACCT | 4,012 | 4,012 | ||
| DISB. FOR CHARITABLE PURPOSES | -38,585 | 38,585 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| DAY HAB PROGRAM | 286,961 | 286,961 | |
| ICF/MR REVENUE | 3,035,359 | 3,035,359 | |
| MISCELLANEOUS REVENUE | 7,269 | 7,269 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| DUE TO/FROM NCA | 51,213 | 171,414 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MANAGEMENT FEE EXPENSE | 40,000 | 40,000 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PROVIDER AND OTHER TAXES | 196,500 | 196,500 |