Amended Annual Mid Year Supplemental (2017) for TENNESSEE CAPTIVE INSURANCE ASSOCIATION INC. PAC submitted on 07/11/2017
Beginning Balance
$1,671.17
Receipts
Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
| Contributor | C/P | Date | Amount |
|---|---|---|---|
|
HILL
, TIMOTHY
P.O. BOX 3071 BLOUNTVILLE , TN 37617 |
C | 11/14/2016 | $205.00 |
|
LUNDBERG
, JON
212 SKYLINE DRIVE BRISTOL , TN 37620 |
C | 11/14/2016 | $2,800.00 |
|
MORTON
, GALE
1490 BULLOCK HOLLOW ROAD BRISTOL , TN 37620 RETIRED |
11/14/2016 | $105.00 | |
|
RAMSEY
, RON
3311 HWY. 126 BLOUNTVILLE , TN 37617 |
C | 11/14/2016 | $240.00 |
|
STAUBUS
, BARRY
397 CARLTON RD BRISTOL , TN 37620 DISTRICT ATTORNEY SULLIVAN COUNTY TENNESSEE |
11/14/2016 | $110.00 | |
|
TALIAFERRO
, BILL
ISLAND RD BLOUNTVILLE , TN 37617 STATE TROOPER STATE OF TENNESSEE |
11/14/2016 | $105.00 | |
|
TINSLEY
, SHEENA
408 BEULAH LAND DR BLUFF CITY , TN 37618 REGISTER OF DEEDS SULLIVAN COUNTY TN |
11/14/2016 | $285.00 | |
|
VANCE
, KELLY
124 BAREFOOT LANDINGS DRIVE BLOUNTVILLE , TN 37617 TEACHER BRISTOL TN SCHOOL SYSTEM |
11/14/2016 | $275.00 |
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
(other than adjustments, loans, and interest)
$5,200.00
Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$5,200.00
Disbursements
Expenditures, Unitemized
| Purpose | Amount |
|---|---|
| NFRW PROGRAMS/FUNDS | $45.00 |
Expenditures, Itemized
| Vendor | C/P | Purpose | In-Kind | Independent | S/O | Date | Amount |
|---|---|---|---|---|---|---|---|
|
CRAWFORD
, JOHN
1606 FOREST VIEW DRIVE KINGSPORT , TN 37660 |
C | CAMPAIGN CONTRIBUTIONS | 11/21/2016 | $500.00 | |||
|
DAVIDSON COUNTY REPUBLICAN PARTY
P.O. BOX 158419 NASHVILLE , TN 37215 |
P | FUNDRAISING MERCHANDISE | 11/02/2016 | $305.00 | |||
|
FAMILY PROMISE OF BRISTOL
P. O. BOX 320 BRISTOL , TN 37621 |
CHARITY CONTRIBUTION | 11/02/2016 | $200.00 | ||||
|
HEALING HANDS HEALTHCARE
210 MEMORIAL DRIVE BRISTOL , TN 37620 |
CHARITY CONTRIBUTION | 11/02/2016 | $200.00 | ||||
|
LUNDBERG
, JON
212 SKYLINE DRIVE BRISTOL , TN 37620 |
C | CAMPAIGN CONTRIBUTIONS | 11/21/2016 | $500.00 | |||
|
NEAL
, BOB
361 BLOUNTVILLE HWY BRISTOL , TN 37620 |
RED TRUNK CATERING | 11/21/2016 | $1,368.00 | ||||
|
ST JUDE CHILDREN'S HOSPITAL
501 ST JUDE PL MEMPHIS , TN 38105 |
CHARITY CONTRIBUTION | 11/02/2016 | $200.00 | ||||
|
TFRW
186 VANTAGE POINTE COUNCE , TN 38326 |
DUES | 11/03/2016 | $112.00 |
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
(other than adjustments)
$3,010.42
Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$3,010.42
Ending Balance
ENDING BALANCE
$3,860.75
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