| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE | FMV | 670,825 | 670,825 |
| MUTUAL FUND | FMV | 3,165 | 3,165 |
| MUTUAL FUND | FMV | 173,037 | 173,037 |
| Description | Amount |
|---|---|
| UNREALIZED LOSS ON LIFE INSURANCE CSV | 2,025 |
| FEDERAL EXCISE TAX PAID | 43 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MANAGEMENT FEES | 1,081 | 1,081 | 0 | 0 |
| SERVICE FEES | 30 | 30 | 0 | 0 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN ON MUTUAL FUND | 6,341 |
| Name | Address |
|---|---|
| GLORIA J PLOURDE |
14 SEARS ROAD SOUTHBORO,MA01772 |