| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL & ACCOUNTING | 650 | 325 | 325 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| OFFICE CONDO | 2007-05-04 | 447,201 | 124,709 | SL | 39.000000000000 | 11,467 | 11,467 | ||
| LAND | 2007-05-04 | 50,000 | L | 0 | 0 | ||||
| COMPUTER | 2013-02-04 | 3,532 | 3,532 | 200DB | 5.000000000000 | 0 | 0 | ||
| 2013 SERVER | 2013-04-10 | 2,073 | 2,013 | 200DB | 5.000000000000 | 60 | 0 | ||
| AC UNIT OFFICE | 2016-10-12 | 10,260 | 7,119 | 200DB | 7.000000000000 | 897 | 1,466 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| CONTROLLED ENTITY INFORMATION | FORM 990-PF, PART VII-A, LINE 11 | OSF OF TENNESSEE, LLC7216 WELLINGTON DRIVE, SUITE 1KNOXVILLE, TN 37919EIN # 20-3115882DESCRIPTION OF TRANSFERS FROM THE LLC:CASH $25,000 |
| DETAIL INFO REQUEST | FORM 990-PF, PART II, LINE 10B AND LINE 10C | THE INSTRUCTIONS FOR FORM 990 -PF REQUIRE A SCHEDULE THAT LISTS EACH SECURITY HELD AT THE END OF THE YEAR, AND TO SHOW WHETHER THAT SECURITY IS REPORTED AT COST BASIS OR FMV. ALL SECURITIES ARE HELD IN A BROKERAGE ACCOUNT THROUGHOUT THE YEAR AND ARE REPORTED AT COST. THIS SCHEDULE CAN BE PROVIDED TO THE IRS AT THEIR REQUEST. |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| CORPORATE BONDS | 322,710 | 323,970 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| CORPORATE STOCK | 163,723 | 233,061 |
| Category/ Item | Cost/Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| OFFICE CONDO | 447,201 | 136,176 | 311,025 | 235,000 |
| LAND | 50,000 | 0 | 50,000 | 25,000 |
| COMPUTER | 3,532 | 3,532 | 0 | 0 |
| 2013 SERVER | 2,073 | 2,073 | 0 | 0 |
| AC UNIT OFFICE | 10,260 | 8,016 | 2,244 | 0 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MISCELLANEOUS | 435 | 0 | 456 | |
| TELEPHONE | 1,559 | 780 | 779 | |
| INSURANCE | 4,439 | 3,639 | 800 | |
| BANK CHARGE - RENTAL | 24 | 24 | 0 | |
| INSURANCE - RENTAL | 2,239 | 2,239 | 0 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| LEASE DEPOSIT | 2,670 | 2,670 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT MANAGEMENT FEES | 6,544 | 6,544 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PAYROLL | 1,707 | 1,138 | 569 | |
| FOREIGN TAXES | 147 | 147 | 0 | |
| ANNUAL REPORT | 20 | 0 | 20 | |
| TN ANNUAL REPORT - RENTAL | 307 | 307 | 0 | |
| PROPERTY TAX - RENTAL | 2,549 | 2,549 | 0 |