| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Accounting fee | 170 | 0 | 0 | 170 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| Investment portfolio | 150,958 | 150,958 |
| Category/ Item | Cost/Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| Land | 0 | 0 | 0 | 0 |
| Buildings | 0 | 0 | 0 | 0 |
| Leasehold improvements | 0 | 0 | 0 | 0 |
| Equipment | 0 | 0 | 0 | 0 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| Annual report fee to Arizona | 10 | 0 | 0 | 10 |
| Description | Amount |
|---|---|
| Decrease in portfolio value | 344 |
| Name | Address |
|---|---|
| Theodore Sarns |
1550 Pelican Ave Naples,FL34102 |