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Amended 1st Quarter for EYE M.D.S PAC submitted on 04/16/2012

Beginning Balance

$1,828.06

Receipts

Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
ARRINDELL , EVERTON
345 23RD AVENUE N, SUITE 350
NASHVILLE , TN 37203
PHYSICIAN
SELF
03/17/2009 $1,000.00
GROOS, JR. , ERICH
2400 PATTERSON STREET
NASHVILLE , TN 37203
PHYSICIAN
SELF
03/17/2009 $500.00
STERNBURG, JR. , PAUL
2311 PIERCE AVE
NASHVILLE , TN 37232-0025
PHYSICIAN
VANDERBILT EYE INSTITUTE
03/17/2009 $1,000.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$7,200.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$7,200.00

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
SUNTRUST BANK
HWY 96 MURFREESBORO ROAD
FRANKLIN , TN 37064
BANK FEES 03/17/2009 $42.00
TRANSFIRST HEALTH SERVICES MERCHANT CARD
7400 W. 110TH STREET, #500
OVERLAND PARK , KS 66210
CREDIT CARD PROCESS 03/17/2009 $211.04
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$62.62

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$62.62

Ending Balance

ENDING BALANCE
$8,965.44


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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