| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING | 17,800 | 17,800 | 0 |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| AVISTA CAPITAL HOLDINGS LP | AT COST | 17,417 | 17,417 |
| MARKETABLE SECURITIES | AT COST | 3,521,892 | 4,189,499 |
| ORTHOBOND STOCK | AT COST | 53,920 | 53,920 |
| AVISTA MANAGER HOLDINGS LP | AT COST | 1,783,896 | 1,783,896 |
| AVISTA HEALTHCARE PARTNERS III LP | AT COST | 1,001,912 | 1,001,912 |
| AVISTA GP HOLDINGS LP | AT COST | 193,743 | 193,743 |
| INVESTMENT IN AHP III AIV | AT COST | 355,144 | 355,144 |
| AVISTA HEALTHCARE COINVESTMENT VEHICLE , LP | AT COST | 5,699 | 5,699 |
| Description | Amount |
|---|---|
| FEDERAL EXCISE TAX | 5,000 |
| BOOK/TAX DIFFERENCE | 67,739 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MANAGEMENT FEES | 10,238 | 10,238 | 0 | |
| PORTFOLIO DEDUCTIONS | 19,612 | 19,612 | 0 | |
| FOREIGN CURRENCY LOSS | 1,009 | 1,009 | 0 | |
| FILING FEES | 600 | 600 | 0 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| AVISTA HEALTHCARE COINVESTMENT VEHICLE, LP | 560 | 560 | 560 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| CREDIT CARD PAYABLE | 37,000 | 5,000 |
| AVISTA GP HOLDINGS LP | 8,838 | 0 |
| Name | Address |
|---|---|
| DAVID BURGSTAHLER |
1160 PARK AVENUE - 12D NEW YORK,NY10128 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FOREIGN TAXES | 31 | 31 | 0 | |
| PAYROLL TAXES AND RELATED EXPENSES | 11,971 | 11,971 | 0 |