| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Accounting | 1,625 | 0 | 0 | 1,625 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| Edward Jones A/C | 368,999 | 486,360 |
| Item No. | 1 |
|---|---|
| Lender's Name | New York Life Insurance Co |
| Lender's Title | |
| Relationship to Insider | None |
| Original Amount of Loan | 82,680 |
| Balance Due | 126,906 |
| Date of Note | 2012-02 |
| Maturity Date | |
| Repayment Terms | None |
| Interest Rate | 5.5000 |
| Security Provided by Borrower | CSV of Life Insurance Policy |
| Purpose of Loan | Borrowed to pay premiums |
| Description of Lender Consideration | |
| Consideration FMV | 126906 |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| CSV of whole life insurance policy | 995,801 | 1,036,578 | 1,036,578 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Annual filing fee | 20 | 20 | ||
| Office expenses | 18 | 18 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| Increase in CSV | 40,204 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Registered agent | 120 | 0 | 0 | 120 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Foreign tax | 86 | 86 | ||
| Investments tax | 1,152 | 1,152 |