| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| LIFE INSURANCE | FMV | 560,169 | 560,169 |
| MUTUAL FUND | FMV | 2,872 | 2,872 |
| MUTUAL FUND | FMV | 182,289 | 182,289 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN ON LIFE INSURANCE CSV | 42,948 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| MANAGEMENT FEES | 595 | 595 | 0 | 0 |
| STATE FILING FEES | 70 | 0 | 0 | 0 |
| SERVICE FEES | 30 | 30 | 0 | 0 |
| Description | Amount |
|---|---|
| UNREALIZED GAIN ON MUTUAL FUND | 12,322 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FORM 990-PF TAX | 108 | 0 | 0 | 0 |