| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEES | 1,000 | 1,000 | 0 |
| Identifier | Return Reference | Explanation |
|---|---|---|
| CONTRIBUTIONS | LINE 1 | SEE ATTACHED SCHEDULE B |
| TAXES | LINE 18 | FEDERAL EXCISE TAXES 317 |
| SCHEDULE OF INVESTMENTS- BOOK | LINE 10 | BOOK MUTUAL FUNDS 1. FIDELITY 500 INDEX FUND (614.506 SHARES) $90,000.00 2. FIDELITY STRATEGIC DIV & INC FND (3,240.779 SHRS) 40,000.00 3. FIDELITY PURITAN FUND(2,553.231 SHARES) 50,000.00 4. FIDELITY VALUE FUND (5,827.700 SHARES) 36,297.45 5. ARTISAN MID CAP FUND (628.253 SHARES) 20,000.00 6. FIDELITY CAPITAL & INCOME FUND(6,553.519 SHARES) 70,000.00 COMMON STOCKS7. JOHN HANCOCK PREFERRED INC FUND III (3,400 SHRS) 81,019.13OTHER8. WELLS FARGO BANK NATL ASSN CD (20,000.000 SHARES) 20,000.009. MISC OTHER $1,525.00 TOTAL 408,841.58 |
| SCHEDULE OF INVESTMENTS- FMV | LINE 10 | FMVMUTUAL FUNDS 1. FIDELITY 500 INDEX FUND (614.506 SHARES) $101,694.602. FIDELITY STRATEGIC DIV & INC FND (3,240.779 SHRS) 51,463.57 3. FIDELITY PURITAN FUND(2,553.231 SHARES) 59,490.28 4. FIDELITY VALUE FUND (5,827.700 SHARES) 83,685.77 5. ARTISAN MID CAP FUND (628.253 SHARES) 21,850.63 6. FIDELITY CAPITAL & INCOME FUND(6,553.519 SHARES) 63,241.46 COMMON STOCKS7. JOHN HANCOCK PREFERRED INC FUND III (3,400 SHRS) 48,076.00OTHER8. WELLS FARGO BANK NATL ASSN CD (20,000.000 SHARES) 19,950.60TOTAL 449,452.91 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| FIDELITY MUTUAL FUNDS & STOCKS | 408,842 | 449,453 |
| Description | Amount |
|---|---|
| BOOK TO TAX ADJUSTMENT | 764 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| FED EXCISE TAX PAYABLE | 500 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| TAXES | 317 | 317 | 0 |