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Annual Year End Supplemental (2009) for BLUE CROSS BLUE SHIELD OF TN PAC submitted on 01/19/2010

Beginning Balance

$25,389.74

Receipts

Monetary Contributions, Unitemized
$5,107.72
Monetary Contributions, Itemized
$0.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$14,917.72

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$14,917.72

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
GILMORE , BRENDA
107 CUNNIFF PARKWAY
GOODLETTSVILLE , TN 37072
C CAMPAIGN CONTRIBUTION 10/16/2018 $1,000.00
HAZLEWOOD , PATSY
P.O. BOX 324
SIGNAL MOUNTAIN , TN 37377
C CAMPAIGN CONTRIBUTION 10/16/2018 $2,500.00
LOVE, JR. , HAROLD M.
2516 BUCHANAN ST.
NASHVILLE , TN 37208
C CAMPAIGN CONTRIBUTION 10/01/2018 $500.00
LYNN , SUSAN
388 GREEN HARBOR RD.
OLD HICKORY , TN 37138
C CAMPAIGN CONTRIBUTION 10/25/2018 $500.00
MARSH , PAT
2105 HWY. 130 E
SHELBYVILLE , TN 37160
C CAMPAIGN CONTRIBUTION 10/01/2018 $1,000.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$32,900.00

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$32,775.00

Ending Balance

ENDING BALANCE
$7,532.46


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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