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Annual Year End Supplemental (2017) for AMERIGROUP TENNESSEE, INC. submitted on 01/29/2018

Beginning Balance

$0.00

Receipts

Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
KPAC
126 S. MAIN STREET
ELIZABETHTON , TN 37643
P 8/24/2010 $1,000.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$28,750.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$28,750.00

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
FAULKNER , JOHNNY CHAD
150 SALLINGS ROAD
LUTTRELL , TN 37779
C CONTRIBUTION 09/09/2010 $250.00
POWERS , DENNIS
P.O. BOX 179
JACKSBORO , TN 37757
C CONTRIBUTION 08/24/2010 $1,000.00
WIRGAU , TIMOTHY
130 ABBOTT LANE
PARIS , TN 38242
C CONTRIBUTION 08/09/2010 $250.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$28,750.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$28,750.00

Ending Balance

ENDING BALANCE
$0.00


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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