3890 (Cont.),,FORM CMS-1984-99,,,,,04-99
,,PROVIDER NO:,,PERIOD:,,,
STATEMENT  OF  CHANGES  IN  FUND  BALANCES,,,,FROM,,  WORKSHEET  G - 1,
,,,,TO,,,
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,,,GENERAL ,SPECIFIC ,ENDOWMENT,PLANT  FUND,
,,,FUND,PURPOSE  FUND,FUND,,
,,,1,2,3,4,
1 ,Fund balances at beginning of period,,,,,,1 
2 ,"Net income (loss) (From Wkst. G-2, line 16)",,,,,,2 
3 ,Total (Sum of line 1 and line 2),,,,,,3 
4 ,Additions (Credit adjustments)  (Specify),,,,,,4 
5 ,,,,,,,5 
6 ,,,,,,,6 
7 ,,,,,,,7 
8 ,,,,,,,8 
9 ,,,,,,,9 
10 ,Total additions (Sum of lines 4 - 9),,,,,,10 
11 ,Subtotal (Line 3 plus line 10),,,,,,11 
12 ,Deductions (Debit adjustments) (Specify),,,,,,12 
13 ,,,,,,,13 
14 ,,,,,,,14 
15 ,,,,,,,15 
16 ,,,,,,,16 
17 ,,,,,,,17 
18 ,Total deductions (Sum of lines 12 - 17),,,,,,18 
19 ,Fund balance at end of period per balance,,,,,,19 
,sheet (Line 11 minus line 18),,,,,,
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"FORM CMS 1984-99 (4-99) (INSTRUCTIONS FOR THIS WORKSHEET ARE PUBLISHED IN CMS PUB.15 - II, SECTION 3850.1 )",,,,,,,
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38-122,,,,,,,Rev. 1