| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPARATION SERVICES | 6,695 | 6,695 |
| 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 |
|---|
| Name of Bond | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE ATTACHMENT | 6,371,514 | 6,371,514 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| SEE ATTACHMENT | 14,013,783 | 14,013,783 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| SEE ATTACHMENT | FMV | 6,297,001 | 6,297,001 |
| 8VC OPPORTUNITIES FUND II, LP | FMV | 300,000 | 300,000 |
| Description | Amount |
|---|---|
| SHORT TERM DISALLOWED LOSS | 230,556 |
| ADJUSTMENT TO BASIS | 25,701 |
| ADDITIONAL ADJUSTMENT | 30,563 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| BANK CHARGES | 6,139 | 6,139 | ||
| MEMBERSHIP FEES | 18,050 | 18,050 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| PARTNERSHIP INCOME | 3,437 | ||
| Return of capital | 78,392 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| DEFERRED TAXES | 15,188 | |
| TAXES PAYABLE | 17,002 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| NCR ADMINISTRATION FEES | 99,240 | 99,240 | ||
| INVESTMENT MANAGEMENT FEES | 78,293 | 78,293 | ||
| CONSULTING FEES | 79,038 | 79,038 |
| Item No. | 1 |
|---|---|
| Borrower's Name | NCR CORPORATION |
| Borrower's Title | |
| Original Amount of Loan | 13334 |
| Balance Due | 13334 |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | TAX REFUND IN PROCESS |
| Description of Lender Consideration | |
| Consideration FMV |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEDERAL EXCISE TAX | 24,016 | |||
| FOREIGN TAX WITHHOLDING | 48 |