| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Electronic Submission Fee $169.90 & $80.10 for doing the return | 250 | 0 | 250 | 250 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| Assets | 104,200 | 0 | 104,200 | 104,200 |