| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| ACCOUNTING FEES | 1,350 | 1,350 |
| Name of Stock | End of Year Book Value | End of Year Fair Market Value |
|---|---|---|
| PUBLICLY TRADED SECURITIES | 25,575 | 64,155 |
| Item No. | 1 |
|---|---|
| Lender's Name | |
| Lender's Title | |
| Original Amount of Loan | |
| Balance Due | 285 |
| Date of Note | |
| Maturity Date | |
| Repayment Terms | |
| Interest Rate | |
| Security Provided by Borrower | |
| Purpose of Loan | |
| Description of Lender Consideration | |
| Consideration FMV |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| FEDERAL EXCISE TAX | 57 |