| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE POLICY - CASH SURRENDER VALUE | FMV | 75,508 | 75,508 |
| INVESTMENT | AT COST | 215,514 | 215,870 |
| INVESTMENT | FMV | 200,825 | 200,825 |
| Description | Amount |
|---|---|
| M-1 IRS PAYMENTS | 268 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN (LOSS) ON LIFE INSURANCE | 18,893 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNT MGT FEE | 25 | 0 | 0 |