| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEES | 2,500 | 0 | 0 |
| Description | Beginning of Year - Book Value | End of Year - Book Value | End of Year - Fair Market Value |
|---|---|---|---|
| PACIFIC MARINER 7 FIXED ANNUITY | 300,000 | 300,000 | 319,217 |
| AMERICAN PATHWAY FA II 7 FIXED ANNUITY | 300,000 | 300,000 | 320,612 |
| AMERICAN PATHWAY FA II 7 FIXED ANNUITY | 300,000 | 307,738 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXEMPTION STATUS ANNUAL REPORT | 20 | 0 | 0 |
| Name | Address |
|---|---|
| JEFFERY AND SUSAN DAVIS |
21305 NW 48TH CT RIDGEFIELD,WA98642 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEDERAL TAXES | 210 | 0 | 0 |