| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PROFESSIONAL FEES | 3,000 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| VARIABLE ANNUITY JACKSON NAT'L LIFE | FMV | ||
| INVESTMENTS | FMV | 286,626 | 286,626 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| SURRENDER CHARGES | 740 | 740 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| 1099-R JACKSON ANNUITY | 27,277 | 27,277 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN ON INVESTMENTS | 1,686 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEDERAL TAXES | 1,452 | 1,452 |