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Amended Annual Mid Year Supplemental (2009) for TE PAC-TN submitted on 09/22/2009

Beginning Balance

$51,747.55

Receipts

Monetary Contributions, Unitemized
$0.00
Monetary Contributions, Itemized
Contributor C/P Date Amount
BREEDEN , ROBERT
2869 PERSIAN LANE
NEW MARKET , TN 37820
ADMINISTRATOR
THE HERITAGE CENTER
07/23/2018 $650.00
ESTES , LINDA
502 STONEHURST COURT
MT. JULIET , TN 37122
CLINICAL SERVICES DIRECTOR
TENNESSEE HEALTH CARE ASSOC
07/05/2018 $162.60
HODGES , ANGIE
5120 VIRGINIA WAY
BRENTWOOD , TN 37027
DIRECTOR OF ASSISTED LIVING
THCA
07/05/2018 $300.00
REDDISH , REINA
5120 VIRGINIA WAY, STE. A21
BRENTWOOD , TN 37027
DIR GOVT AFFAIRS
TN HEALTH CARE ASSN
07/05/2018 $560.28
SAMPLES , JESSE
451 TRUMAN ROAD
FRANKLIN , TN 37064
EXECUTIVE DIRECTOR
TENNESSEE HEALTH CARE ASSN
07/05/2018 $600.00
WINNINGHAM , DARRELL
1108 SCRAMBLERS KNOB
FRANKLIN , TN 37069
DEPUTY DIRECTOR
TENNESSEE HEALTHCARE ASSOCIATION
07/05/2018 $576.00
WRIGHT , JAMES
205 PRAIRIE VIEW
FRANKLIN , TN 37064
ADMINISTRATOR
WEST MEADE PLACE
07/23/2018 $248.10
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$4,965.00

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$4,965.00

Disbursements

Expenditures, Unitemized
Purpose Amount
BANK FEES $1.35
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
CAS-PAC
2113 EMERY LANE
FRANKLIN , TN 37064
P CONTRIBUTION 07/17/2018 $5,000.00
FAISON , JEREMY
P.O. BOX 516
NEWPORT , TN 37822
C CONTRIBUTION 07/17/2018 $500.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$7,889.20

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$7,889.20

Ending Balance

ENDING BALANCE
$48,823.35


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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