| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE POLICY: SEE EXHIBIT | 16,036 | 16,036 | |
| 1 ATTACHED | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL FEES | 376 | 376 | 376 | 376 |
| Description | Amount |
|---|---|
| DECREASE IN CSV OF LIFE INSURANCE | 2,261 |
| ROUNDING ERROR | 1 |
| Name | Address |
|---|---|
| RONALD ANDERSON JR |
JENNY ANDERSON LINCOLN,NE68516 |
| JENNY ANDERSON |
JENNY ANDERSON LINCOLN,NE68516 |