| 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 |
|---|
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| SYMETRA - FLEX PREMIUM ADJ LIF | 309,434 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Administrative Fees | 5,000 | 5,000 | ||
| BANK CHARGES | 67 | 67 | ||
| LIFE INSURANCE EXPENSE | 333,849 | |||
| State or Local Filing Fees | 25 | 25 |