| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| INDIRECT ACCOUNTING FEES | 1,900 |
| Lender's Name | Lender's Address | Amount Borrowed | Use of Borrowed Funds | Election Statement |
|---|---|---|---|---|
|
AMERICAN EXPRESS |
|
TRAVEL AND CHARITABLE DONATIONS |
| Category/ Item | Listed at Cost or FMV | Book Value | End of Year Fair Market Value |
|---|---|---|---|
| OTHER INVESTMENTS | AT COST | 674,277 | 270,490 |
| Category / Item | Cost / Other Basis | Accumulated Depreciation | Book Value | End of Year Fair Market Value |
|---|---|---|---|---|
| FIXED ASSETS | 9,042 | 9,042 |
| Description | Revenue and Expenses per Books | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| EXPENSES | ||||
| DUES AND SUBSCRIPTIONS | 978 | |||
| BANK SERVICE CHARGES | 264 | |||
| MEDICAL SUPPLIES | 637 | |||
| COMPUTER SOFTWARE | 250 | |||
| WESTERN IRB | 3,270 |
| Description | Beginning of Year - Book Value | End of Year - Book Value |
|---|---|---|
| CREDIT CARD PAYABLE | 2,581 | 248 |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| PAYROLL SERVICE FEES | 714 | |||
| INVESTMENT MANAGEMENT FEES |
| Category | Amount | Net Investment Income | Adjusted Net Income | Disbursements for Charitable Purposes |
|---|---|---|---|---|
| LICENSE & PERMITS | 160 | |||
| TAXES | 498 | |||
| PAYROLL TAXES | 4,590 |