Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INVESTMENT INCOME. AMOUNT: 3,845. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: OTHER EXPENSES. AMOUNT: 89,772. |
| FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS | DESCRIPTION: OTHER CHANGES. AMOUNT: -25,745. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: RECEIVABLE FROM SHAREHOLDER. BEG. OF YEAR AMOUNT: 5,000. END OF YEAR AMOUNT: 5,000. |
| FORM 990-EZ, PART II, LINE 26 - OTHER LIABILITIES | DESCRIPTION: ACCOUNTS PAYABLE. BEG. OF YEAR AMOUNT: 1,700. END OF YEAR AMOUNT: 1,700. DESCRIPTION: UNEARNED PREMIUMS. BEG. OF YEAR AMOUNT: 211,336. END OF YEAR AMOUNT: 262,244. DESCRIPTION: UNPAID LOSSES. BEG. OF YEAR AMOUNT: 0. END OF YEAR AMOUNT: 2,577. |
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