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Amended 3rd Quarter for INDEPENDENT MEDICINE'S PAC-TN submitted on 11/08/2004

Beginning Balance

$55,798.63

Receipts

Monetary Contributions, Unitemized
$10,370.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
NEWTON , CAROL
6409 CHELTENHAM RD.
HIXON , TN 37343

10/07/2004 $100.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$106,019.16

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$29.50
TOTAL RECEIPTS
$106,048.66

Disbursements

Expenditures, Unitemized
Purpose Amount
POSTAGE $15.17
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
HERRON , ROY
142 WEST MAIN
DRESDEN , TN 38225
C CONTRIBUTION 12/14/2004 $100.00
MCLEARY , DON
125 ED SMITH ROAD
HUMBOLDT , TN 38343
C CONTRIBUTION 10/20/2004 $100.00
OVERBEY , DOUG
2113 WATERLOO DRIVE
MARYVILLE , TN 37803
C CONTRIBUTION 10/20/2004 $100.00
TRAIL , LARRY
1011 HOUSTON DRIVE
MURFREESBORO , TN 37130
C CONTRIBUTION 10/20/2004 $100.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$119,644.93

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$119,644.93

Ending Balance

ENDING BALANCE
$42,202.36


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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