EFTA00133440



To Remove Document Fold and Tear Along This Perforation






EFTA00133441

## Electronic Deposit Image

DATE-TIME: 2019-07-27 16:24:02

$76.50

ATM Terminal ID: B0012011

Transaction Sequence: 291944

CARD:

Signer1: ROBERTO GRIJALVA

Signer2: CHARLENE NIEVES