EFTA00133444



PAY **Six Thousand Eight Hundred Sixty and 50/100 s**



CHECK AMOUNT

$**6,860.50





TO ROBERTO GRIJALVA AND CHARLENE GRIJALVA



THE AND USAA FSB

ORDER

OF:



USAA #: 017866327 / LR #: 12



NATURE OF PAYMENT:

Payment under Dwelling coverage less $ 1000.00 deductible less recoverable depreciation

BANK OF AMERICA • HARTFORD, CT

VOID 180 DAYS FROM ISSUE DATE

AUTHORIZED SIGNATURE

EFTA00133445

## Electronic Deposit Image

DATE-TIME: 2019-08-11 15:58:26

$$431.10$$

ATM Terminal ID: B0012011

Transaction Sequence: 300739

CARD:

Signer1: ROBERTO GRIJALVA

Signer2: CHARLENE NIEVES