| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAX PREPARATION FEES | 950 | 950 | 0 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990-PF, PG 4 ITEM 8B | THE STATE OF NEVADA DOES NOT HAVE A FILING REQUIREMENT |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| CORPORATE STOCK | 47,878 | 63,889 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| JACKSON NATIONAL LIFE INSURANCE AND ANNUITY | AT COST | 24,626 | 26,333 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INVESTMENT EXPENSES | 10 | 10 | 0 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| ANNUITY JACKSON NATIONAL | 2,718 | 2,718 | 2,718 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INCOME TAX | 7 | 0 | 0 |