| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE | FMV | 646,435 | 646,435 |
| MUTUAL FUND | FMV | 3,299 | 3,299 |
| MUTUAL FUND | FMV | 164,211 | 164,211 |
| Description | Amount |
|---|---|
| UNREALIZED LOSS ON LIFE INSURANCE CSV | 16,644 |
| FEDERAL EXCISE TAX PAID | 61 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MANAGEMENT FEES | 970 | 970 | 0 | 0 |
| STATE FILING FEES | 35 | 0 | 0 | 0 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN ON MUTUAL FUND | 34,019 |
| Name | Address |
|---|---|
| GLORIA J PLOURDE |
14 SEARS ROAD SOUTHBORO,MA01772 |