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Amended 4th Quarter for BLUE CROSS BLUE SHIELD OF TN PAC submitted on 01/11/2005

Beginning Balance

$12,427.71

Receipts

Monetary Contributions, Unitemized
$3,345.62
Monetary Contributions, Itemized
Contributor C/P Date Amount
GREGG , VICKY
801 PINE ST
CHATTANOOGA , TN 37402
President and CEO
BlueCross BlueShield of TN
07/24/2006 $125.00
YOUNG , WILLIAM
801 PINE ST
CHATTANOOGA , TN 37402
Sr. VP \& Gen. Counsel
BlueCross BlueShield of TN
07/24/2006 $130.00
TOTAL CONTRIBUTIONS
(other than adjustments, loans, and interest)
$4,290.62

Contribution Adjustments
$0.00
Loans Received
$0.00
Interest Received This Reporting Period
$0.00
TOTAL RECEIPTS
$4,290.62

Disbursements

Expenditures, Unitemized
$0.00
Expenditures, Itemized
Vendor C/P Purpose In-Kind Independent S/O Date Amount
HARPER , THELMA
2722 SCOVEL STREET
NASHVILLE , TN 37208
C CONTRIBUTION 07/13/2006 $500.00
Loan Payments
$0.00
Obligation Payments
$0.00
TOTAL EXPENDITURES
(other than adjustments)
$10,375.99

Expenditures, Adjustments
$0.00
TOTAL DISBURSEMENTS
$10,375.99

Ending Balance

ENDING BALANCE
$6,342.34


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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