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4th Quarter for TENNESSEE CAPTIVE INSURANCE ASSOCIATION INC. PAC submitted on 01/16/2015

Beginning Balance

$11,700.56

Receipts

Monetary Contributions, Unitemized
$34.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
ROLLER , STEVE
111 WEST COURT SQUARE, SUITE 1
MCMINNVILLE , TN 37110
C 1/15/2009 $850.00
ROLLER , STEVE
111 WEST COURT SQUARE, SUITE 1
MCMINNVILLE , TN 37110
C 01/15/2009 $2,242.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$4,757.01

Contributor C/P Date Amount
WILLIAMS ENTERPRISES
3333 ENTERPRISE DRIVE
COOKEVILLE , TN 38506
01/15/2009 [ $200.00 ]
Contribution Adjustments
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$4,757.01

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
PC SIGNS
2534 COMMERCE BLVD
CINCINNATI , OH 45241
SETTLEMENT OF SERVICES FOR CAMPAIGN SIGNS 01/15/2009 $1,250.00
TN DEPARTMENT OF LABOR & WORKFORCE DEV.
P.O. BOX 101
NASHVILLE , TN 37202
PAYROLL TAXES 10/31/2008 $171.45
UNITED STATES TREASURY (IRS)
324 25TH STREET
OGDEN , UT 84401
PAYROLL TAXES 10/31/2008 $1,870.55
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$3,747.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$3,747.00

Ending Balance

ENDING BALANCE
$12,710.57


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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