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Pre-General for COMMUNITY HEALTH SYSTEMS PROFESSIONAL SVCS PAC submitted on 11/06/2012

Beginning Balance

$80,895.00

Receipts

Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
BLACKBURN FOR CONGRESS
PO BOX 682185
FRANKLIN , TN 37068
07/02/2012 $300.00
CROY , JAMES
5245 LYSANDER LANE
BRENTWOOD , TN 37027
REAL ESTATE
SELF
07/18/2012 $1,000.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$0.00

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

Disbursements

Expenditures, Unitemized
Purpose Amount
INTERNET SERVICE $72.26
POSTAGE $90.00
TN DEPT OF LABOR $3.67
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
AT&T
4255 S CAROTHERS RD
FRANKLIN , TN 37067
TELEPHONE 07/18/2012 $231.40
CINCINNATI INSURANCE
PO BOX 145620
CINNINNATI , OH 42250-5620
INSURANCE PREMIUM 07/18/2012 $189.00
JOHNSON , JODIE
4121 HILLSBORO RD
NASHVILLE , TN 37215
RENT 07/02/2012 $1,650.00
US TREASURY
P O BOX 804522
CINCINNATI , OH 45280-4522
PAYROLL TAXES 07/02/2012 $569.71
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$12,500.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$12,500.00

Ending Balance

ENDING BALANCE
$68,395.00


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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