| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEES | 8,600 |
| Person Name | Explanation |
|---|---|
| MARY NATIONS SMITH | |
| SARAH FOSTER | |
| SONYA KIMBLE | |
| MARY CLARK | |
| CAROLYN ROUNSAVILLE | |
| BETTY SPILLER | |
| LISA MITCHELL |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| LAND | 1965-04-01 | 35,057 | |||||||
| LANDSCAPING | 1996-10-01 | 259,481 | 259,481 | S/L | 10.0000 | ||||
| CONCRETE EAST SIDE | 1997-01-01 | 4,680 | 4,680 | S/L | 10.0000 | ||||
| PERIMETER LAWN SEEDING | 1997-05-01 | 3,437 | 3,437 | S/L | 10.0000 | ||||
| BUILDING-NEW NURSING HOME | 1996-10-01 | 2,172,257 | 932,606 | S/L | 40.0000 | 54,994 | 54,994 | 54,994 | |
| CABINETS & WARDROBES | 1996-10-01 | 42,560 | 18,265 | S/L | 40.0000 | 1,077 | 1,077 | 1,077 | |
| TV WALL BRACKET | 1996-10-01 | 5,141 | 2,205 | S/L | 40.0000 | 130 | 130 | 130 | |
| 34 MIRRORS, 2 SHOWER DOORS | 1996-10-01 | 2,546 | 1,086 | S/L | 40.0000 | 64 | 64 | 64 | |
| ADDITIONAL MIRRORS | 1996-10-01 | 528 | 222 | S/L | 40.0000 | 13 | 13 | 13 | |
| SPRINKLER ANTI-FREEZE LOOP | 1997-01-01 | 2,152 | 825 | S/L | 39.0000 | 56 | 56 | 56 | |
| AIR & HEAT DUCTS TO BATHS | 1997-09-01 | 3,940 | 1,548 | S/L | 39.0000 | 101 | 101 | 101 | |
| NEW BUILDING ADDITION | 2009-07-28 | 490,543 | 55,885 | S/L | 40.0000 | 12,418 | 12,418 | 12,418 | |
| NEW BUILDING ADDITIONS | 2011-06-15 | 24,604 | 1,557 | S/L | 40.0000 | 623 | 623 | 623 | |
| NURSE CALL SYSTEM | 2011-10-14 | 43,651 | 17,460 | S/L | 5.0000 | 8,731 | 8,731 | 8,731 | |
| FACILITY GENERATOR | 2011-03-30 | 186,287 | 31,048 | S/L | 15.0000 | 12,419 | 12,419 | 12,419 | |
| GENERATOR BALANCE | 2012-03-30 | 2,913 | 1,535 | S/L | 3.0000 | 971 | 971 | 971 |
| Name | Date Acquired | How Acquired | Date Sold | Purchaser Name | Gross Sales Price | Basis | Basis Method | Sales Expenses | Total (net) | Accumulated Depreciation |
|---|---|---|---|---|---|---|---|---|---|---|
| STOCK SALE | PURCHASE | 29,694 | 29,694 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| UNREALIZED LOSS ON AFS SECURITIES | FMV | 13,726 | 13,726 |
| INVESTMENTS-EDWARD JONES | FMV | 495,143 | 495,143 |
| INVESTMENTS-MIM | FMV | 494,729 | 494,729 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| BUILDINGS & EQUIPMENT | 3,244,720 | 1,423,437 | 1,821,283 | |
| LAND | 35,057 | 35,057 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL & PROFESSIONAL | 37,376 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| BANK CHARGES | 110 | |||
| OFFICE SUPPLIES & SUBSCRIPTIO | 638 | |||
| COMPUTER EXPENSES | 2,131 | |||
| INVESTMENT EXPENSE- EJ | 939 | |||
| INSURANCE | 44,312 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| OTHER INCOME | 8,057 | 8,057 | |
| COST REPORT SETTLEMENT-SCR | 28,709 | 28,709 | |
| COST REPORT SETTLEMENT INCOME | 72,963 | 72,963 | |
| BAD DEBT COLLECTED | 4,127 | 4,127 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| HELD IN CUSTODY FOR OTHERS | 3,054 | 599 |