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Annual Year End Supplemental (2011) for LIFEPOINT HEALTH PAC submitted on 01/30/2012

Beginning Balance

$124,155.76

Receipts

Monetary Contributions, Unitemized
$1,145.00
Monetary Contributions, Itemized
$0.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$1,145.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$1,145.00

Disbursements

Expenditures, Unitemized
Purpose Amount
BANK FEES $81.25
NON TENN $35,774.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
FORGETY , JOHN W.
120 COUNTY ROAD 447
ATHENS , TN 37303
C FUNDRAISER 08/16/2011 $500.00
MCDANIEL , STEVE
97 BATTLEGROUND DRIVE
PARKERS CROSSROADS , TN 38388
C FUNDRAISER 7/19/11 $250.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$36,605.25

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$36,605.25

Ending Balance

ENDING BALANCE
$88,695.51


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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