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3rd Quarter for TENNESSEE CAPTIVE INSURANCE ASSOCIATION INC. PAC submitted on 10/11/2022

Beginning Balance

$5,287.66

Receipts

Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
BLACKBURN , CHARLES
1008 STEEPLECHASE DRIVE
BRENTWOOD , TN 37027
EXECUTIVE DIRECTOR
TENN ASSOC OF MENTAL HEALTH ORGANIZAITON
07/07/2008 $150.00
GOOD , CHARLES
222 TOWN AND COUNTRY DRIVE
JONESBOROUGH , TN 37659
SENIOR VP - OPERATIONS
FRONTIER HEALTH
07/08/2008 $100.00
GOOD , SHARON
106 SILKWOOD CT
GRAY , TN 37615
Senior Vice President
Frontier Health
07/08/2008 $100.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$0.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$0.00

Disbursements

Expenditures, Unitemized
Purpose Amount
BANK FEES $13.00
PRINTING $79.45
Expenditures, Itemized
$0.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$25.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$10.00

Ending Balance

ENDING BALANCE
$5,277.66


Outstanding Loans


TOTAL OUTSTANDING LOAN BALANCE
$0.00

In-Kind Contributions

In-Kind Contributions are not included in the report ending balance.

Unitemized
$0.00
Itemized
$0.00
TOTAL IN-KIND CONTRIBUTIONS
$0.00

Obligations

Obligations are not included in the report ending balance.

Unitemized
$0.00
Itemized
$0.00
Obligations, Outstanding from Previous Reports
$0.00
TOTAL OBLIGATIONS OUTSTANDING
$0.00

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