| Category | Amount |
|---|---|
| NONE |
| 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 |
|---|
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE STATEMENT 101 | 117,000 | 104,241 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FILING FEES | 50 | 25 | 25 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| OTHER |
| Item No. | 1 |
|---|---|
| Borrower's Name | JIM SCHREIBER |
| Borrower's Title | |
| Original Amount of Loan | 5025 |
| Balance Due | 4979 |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXCISE TAXES | 500 | 500 |