| 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 | 304,590 | 304,590 |
| INVESTMENT | FMV | 286,340 | 286,340 |
| Description | Amount |
|---|---|
| M-1 IRS PAYMENTS | 665 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT FEES | 17 | 0 | 0 | |
| FOREIGN FEES | 20 | 0 | 0 | |
| STATE FEES | 40 | 0 | 0 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN (LOSS) ON LIFE INSURANCE | 70,340 |