| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE | AT COST | 500,000 | 500,000 |
| SECURITIES | FMV | 87,863 | 87,863 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL/PROFESSIONAL | 642 | 642 | ||
| LEGAL FEES | 425 | 425 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| OH FILING FEES | 25 | 25 |
| Description | Amount |
|---|---|
| CHANGE IN VALUE | 12,349 |