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3rd Quarter for BLUE CROSS BLUE SHIELD OF TN PAC submitted on 10/09/2014

Beginning Balance

$40,473.14

Receipts

Monetary Contributions, Unitemized
$3,997.20
Monetary Contributions, Itemized
Contributor C/P Date Amount
DEAL , DAVID
801 PINE ST.
CHATTANOOGA , TN 37402
Sr. VP and CFO
BlueCross BlueShield of TN
06/19/2005 $120.00
GREGG , VICKY
801 PINE ST
CHATTANOOGA , TN 37402
President and CEO
BlueCross BlueShield of TN
06/19/2005 $375.00
HARRIS , JEAN
801 PINE ST.
CHATTANOOGA , TN 37402
VP
BlueCross BlueShield of TN
06/19/2005 $120.00
LAWHORN , DONALD
801 PINE ST
CHATTANOOGA , TN 37402
Sr. Director
BlueCross BlueShield of TN
06/19/2005 $150.00
YOUNG , WILLIAM
801 PINE ST
CHATTANOOGA , TN 37402
Sr. VP \& Gen. Counsel
BlueCross BlueShield of TN
06/19/2005 $390.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$12,009.20

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$12,009.20

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
$0.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$6,500.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$6,500.00

Ending Balance

ENDING BALANCE
$45,982.34


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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