| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LEGAL AND PROFESSIONAL FEES | 4,266 | 4,266 | 0 | 0 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| COMMON STOCK | 294,075 | 294,075 |
| SENSEONICS HOLDINGS, INC STOCK | 38,163 | 38,163 |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| HIGHFIELDS CAPITAL IV | 54,699 | 33,454 | 33,454 |
| Description | Amount |
|---|---|
| BOOK/TAX DIFFERENCE | 834 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| OTHER ADMINISTRATIVE EXPENSES | 141 | 25 | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| CONSULTING FEES | 20,000 | 20,000 | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FORM PC TAX | 125 | 125 | 0 | 0 |
| CA FORM 199 TAX | 10 | 10 | 0 | 0 |