| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PROFESSIONAL FEES | 15,324 | 1,532 | 1,532 | 13,792 |
| 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 |
|---|---|---|---|---|---|---|---|---|---|
| DEPRECIATION | 54,868 | 38,013 | |||||||
| DEPRECIATION - GENERAL | 12,773 | 4,758 |
| Name | Date Acquired | How Acquired | Date Sold | Purchaser Name | Gross Sales Price | Basis | Basis Method | Sales Expenses | Total (net) | Accumulated Depreciation |
|---|---|---|---|---|---|---|---|---|---|---|
| VARIOUS EQUIPMENT AND FURNISHINGS | PURCHASE | 2020-06 | 476 | 72,801 | -353 | 71,972 | ||||
| DISPOSAL OF WALK IN FREEZER | 1986-04 | PURCHASE | 2020-03 | 200 | 4,696 | 200 | 4,696 | |||
| DISPOSAL OF RESIDENT VEHICLE | 2017-12 | PURCHASE | 2020-03 | 5,900 | 7,080 | 1,854 | 3,034 |
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| FIXED INCOME - PNC | 1,774,677 | 1,870,377 |
| FIXED INCOME - NW | 2,148,725 | 2,158,871 |
| FIXED INCOME - FNB | 2,186,341 | 2,244,578 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| EQUITIES - PNC | 4,261,121 | 5,226,796 |
| EQUITIES - NW | 4,130,607 | 5,216,395 |
| EQUITIES - FNB | 3,148,042 | 3,636,689 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| ALTERNATIVE INVESTMENTS | AT COST | 732,270 | 733,897 |
| OIL & GAS RIGHTS | 3,086 | 3,086 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| BUILDINGS & EQUIPMENT | 1,157,479 | 752,172 | 405,307 | 1,157,479 |
| LAND | 8,000 | 8,000 | 8,000 |
| Item No. | 1 |
|---|---|
| Lender's Name | PPP LOAN |
| Lender's Title | |
| Relationship to Insider | |
| Original Amount of Loan | |
| Balance Due | 219,550 |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| UNDEPOSITED ASSETS | 7,005 | 55,165 | 55,165 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| FOOD | 52,175 | 1,836 | 50,339 | |
| RESIDENT - OBLIGATIONS | 18,329 | 18,329 | ||
| NURSING HOME EXPENSE | 44,363 | 44,363 | ||
| MEDICAL | 19,316 | 19,316 | ||
| DRUGS | 19,943 | 19,943 | ||
| FUNERAL EXPENSES | 21,203 | 21,203 | ||
| DUES | 940 | 940 | ||
| ACTIVITIES | 2,567 | 2,567 | ||
| OTHER SERVICES | 3,849 | 3,849 | ||
| RESIDENT - ALLOWANCES | 27,520 | 27,520 | ||
| BACKGROUND & DRUG TESTING | 2,352 | 2,352 | ||
| SUPPLIES | 62,522 | 62,522 | ||
| ADVERTISING | 4,909 | 4,909 | ||
| MISCELLANEOUS EXPENSE | 14,611 | 14,611 | ||
| RANDOM DRUG TESTING | 457 | 457 | ||
| GENERAL INSURANCE | 62,821 | 62,821 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| OTHER INVESTMENT INCOME | 1,157 | 1,157 | 1,157 |
| OIL ROYALTIES | 27 | 27 | 27 |
| EMPLOYEE/GUEST MEALS | 1,836 | 1,836 | |
| ASSETS OF DECEASED GUESTS | 37,281 | 37,281 | |
| RESIDENT - SOCIAL SECURITY | 313,807 | 313,807 | |
| RESIDENT - PENSION & ANNUITIE | 72,383 | 72,383 | |
| RESIDENT - MISCELLANEOUS INCO | 2,242 | 2,242 | |
| RESIDENT - NEW ASSETS | 152,181 | 152,181 | |
| OTHER INCOME | 119 | 119 | |
| STIMULUS PAYMENTS | 22,800 | 22,800 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT MANAGEMENT FEES - PNC | 41,065 | 41,065 | 41,065 | |
| INVESTMENT MANAGEMENT FEES - NW | 38,155 | 38,155 | 38,155 | |
| INVESTMENT MANAGEMENT FEES - FNB | 41,688 | 41,688 | 41,688 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXCISE TAXES | 13,191 | 13,191 | ||
| FOREIGN TAXES | 3,026 | 3,026 | ||
| PAYROLL TAXES | 80,308 | 1,600 | 1,600 | 78,708 |