Mutual Fund




Report a mutual fund and income from the fund in Part 6.

#

Description

EIF

Value

Income Type

Income Amount

1

Janus Balanced Fund (JDBAX)

Yes

$15,001 - $50,000

 

$201 - $1,000

2

ABC Healthcare Fund (ABCHX)

Yes

None (or less than $1,001)

 

$201 - $1,000

For You, Your Spouse, and Your Dependent Children

Part 6

Report a mutual fund if the value of the fund was more than $1,000 at the end of the reporting period or if more than $200 in income was received during the reporting period.

Description:  Provide the exact name of the fund (e.g., write “Janus Balanced Fund”; do not write only “Janus” or “Balanced Fund”).  Providing the ticker symbol is also helpful.

EIF:  Select “Yes.”

Value:  Report the value of the fund by selecting the appropriate category.

Income Type:  Do not complete this field for EIFs.

Income Amount:  Select the category that corresponds to the total amount of income received during the reporting period.

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