| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPARATION FEES | 12,671 | 12,671 |
| Person Name | Explanation |
|---|---|
| WELLS FARGO BANK NA | THE CORPORATE TRUSTEE'S COMPENSATION REPORTED IN COLUMN (C) IS CALCULATED BASED ON PERIODIC MARKET VALUES AND/OR THE APPLICABLE FEE AGREEMENT. IT IS NOT DETERMINED ON AN HOURLY BASIS AND THE REFERENCE TO ONE HOUR PER WEEK IS AN ESTIMATE ONLY. CORPORATE TRUSTEE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, ADMINISTRATIVE SERVICES SUCH AS FIDUCIARY ACCOUNTING, CUSTODY OF ASSETS, COMPLYING WITH TAX FILING REQUIREMENTS, COMPLYING WITH DISTRIBUTION PROVISIONS, AND COMPLYING WITH FEDERAL AND STATE LAWS APPLICABLE TO PRIVATE FOUNDATIONS, PLUS ASSET MANAGEMENT SERVICES SUCH AS CREATING ASSET ALLOCATION STRATEGIES, INVESTMENT REPORTING AND REALLOCATING AND REBALANCING OF PORTFOLIOS AS NECESSARY. |
| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|---|---|---|---|---|---|---|---|---|
| ORIGINAL COST | 1995-09-07 | 109,342 | L | 150 | |||||
| CAPITAL IMPROV. | 1995-09-07 | 5,841 | 3,644 | M39 | 39 | 299 | |||
| CAPITAL IMPROV. | 1995-11-01 | 11,680 | 7,213 | M39 |
| Grantee's Name | Grantee's Address | Grant Date | Grant Amount | Grant Purpose | Amount Expended By Grantee | Any Diversion By Grantee? | Dates of Reports By Grantee | Date of Verification | Results of Verification |
|---|---|---|---|---|---|---|---|---|---|
|
ELIZABETH CITY HEALTH AND REHABILITATION |
1075 US HIGHWAY 17 SOUTH ELIZABETH CITY,NC27909 |
2020-10-30 | 180,000 | TO DEFRAY THE COSTS OF CARING FOR NEEDY PERSONS IN RESIDENCE AT FACILITY(SEE ATTACHED) | 180,000 | NO | 08/05/2021 | 2021-08-05 | SEE ATTACHED |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE ATTACHED ASSET DETAIL | ||
| SCHEDULE | 2,507,732 | 7,136,056 |
| ADJ FOR FMV OF DONATED ASSETS | 3 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| MUTUAL FUND INVESTMENTS - | AT COST | ||
| SEE ATTACHED ASSET DETAIL | |||
| SCHEDULE | AT COST | 10,771,058 | 12,859,508 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| DUE FROM BROKER, DIV INT | 70,669 | 34,393 | 34,393 |
| DUE FROM BROKER , SALE PROCEED | 178,039 | 611,789 | 611,789 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| OTHER INVESTMENT EXPENSES | 38 | 38 | ||
| INSURANCE - RENTAL PROP | 715 | 715 | ||
| APPRAISAL FEE - RENTAL PROP | 2,400 | 2,400 | ||
| Rent and Royalty Expense | 0 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| OTHER | 238 | 238 | |
| REFUND OF INVESTMENT FEES | 836 | 836 |
| Description | Amount |
|---|---|
| BOOK TAX DIFFERENCE FOR CONTRIBUTED | 0 |
| ASSETS REALIZED DURING YEAR | 727 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| SECURITY DEPOSIT |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FOREIGN TAXES | 5,482 | 5,482 | ||
| FEDERAL EXCISE TAX | 11,334 | |||
| REAL ESTATE TAX - RENTAL PROP. | 33,795 | 33,795 |