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Amended Annual Year End Supplemental (2013) for THE JACKSON CLINIC PAC submitted on 03/11/2014

Beginning Balance

$85,219.19

Receipts

Monetary Contributions, Unitemized
$80.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
ROMULUS INC.
191 S. HIGHLAND STREET
MEMPHIS , TN 38111
P 07/05/2013 $500.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$15,975.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$46.23
TOTAL RECEIPTS
$16,021.23

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
FORD , KEMBA
117 FLEETS ISLAND DRIVE
MEMPHIS , TN 38103
CONTRIBUTION 09/27/2013 $250.00
WILLIAMS , W. KENT
126 SOUTH MAIN STREET
ELIZABETHTON , TN 37643
C CONTRIBUTION 07/05/2013 $250.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$5,000.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$5,000.00

Ending Balance

ENDING BALANCE
$96,240.42


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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