POOLED FUND WORKSHEET

  


MARKET VALUE AT BEGINNING OF PERIOD:                          $

PURCHASES BY SYSTEM (1):

DATE:                                                AMOUNT :                 $
DATE:                                                AMOUNT :                 $
DATE:

CHANGES DUE TO INCOME (2):

INVESTMENT INCOME      $                    (LOSS):($ )
REALIZED GAIN                   $                    (LOSS):($ )
UNREALIZED GAIN             $                     (LOSS):($ )

LESS:

MANAGEMEMT FEES (3)                                                                  $

SALES BY SYSTEM (4) *:

DATE:                                                AMOUNT :                 $
DATE:                                                AMOUNT :                 $
DATE:                                                AMOUNT :                 $

STOCK DISTRIBUTION (5) **                                                          $

     $
# of Shares   Name of Stock   Market Value
         
    $
# of Shares      Name of Stock   Market Value
         
     $
# of Shares   Name of Stock   Market Value

MARKET VALUE AT END OF PERIOD                                          $

* Includes income not reinvested and cash distribution to system

** Total market value of new stock should correspond to the decrease in market value of pooled fund.


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