| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| NON QUALIFYING ANNUITY | 99,000 | 127,389 |
| Description | Amount |
|---|---|
| RETURN OF PRINCIPAL FROM ANNUITY | 1,000 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INTERNAL REVENUE SERVICE FILING FEE | 600 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| NEW YORK LIFE 1099R NON QUALIYING ANNUITY | 5,000 | 4,000 | 4,000 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INTERNAL REVENUE SERVICE | 50 |