| Description of Property | Date Acquired | Cost or Other Basis | Prior Years' Depreciation | Computation Method | Rate / Life (# of years) |
Current Year's Depreciation Expense | Net Investment Income | Adjusted Net Income | Cost of Goods Sold Not Included |
|---|
| Grantee's Name | Grantee's Address | Grant Date | Grant Amount | Grant Purpose | Amount Expended By Grantee | Any Diversion By Grantee? | Dates of Reports By Grantee | Date of Verification | Results of Verification |
|---|---|---|---|---|---|---|---|---|---|
|
SEE ATTACHED |
|
NO |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| INVESTMENT IN FA212, LLC | FMV | 4,826,019 | 4,826,019 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| DELAWARE FRANCHISE TAX | 300 | 300 | ||
| NYS FILING FEES | 250 | 250 | ||
| LICENSES AND PERMITS | 881 | 881 | ||
| TAX PREPARATION FEES | 14,410 | 14,410 | ||
| LEGAL FEES | 16,286 | 16,286 | ||
| APP DEVELOPMENT COSTS | 397,541 | 397,541 | ||
| INSURANCE EXPENSE | 17,683 | 17,683 | ||
| OTHER PROFESSIONAL FEES | 32,814 | 32,814 | ||
| BANK CHARGES | 59 | 59 | ||
| TRAVEL EXPENSE | 27,582 | 27,582 |
| Description | Revenue And Expenses Per Books | Net Investment Income | Adjusted Net Income |
|---|---|---|---|
| ORDINARY LOSS THRU K-1 | -443,960 | -443,960 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| GRANTS DECLARED PAYABLE |