| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE | FMV | 656,324 | 656,324 |
| MUTUAL FUND | FMV | 3,098 | 3,098 |
| MUTUAL FUND | FMV | 220,906 | 220,906 |
| Description | Amount |
|---|---|
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| STATE FILING FEES | 35 | 0 | 0 | 0 |
| MANAGEMENT FEES | 1,391 | 1,391 | 0 | 0 |
| SERVICE FEES | 30 | 30 | 0 | 0 |
| Description | Amount |
|---|---|
| Name | Address |
|---|---|
| ROGER P GLORIA J PLOURDE |
14 SEARS ROAD SOUTHBORO,MA01772 |