Financial record · Aug. 11, 2019

Insurance payment check to two private payees, August 2019

A $6,860.50 insurance payment check under dwelling coverage, plus an ATM deposit image signed by the two payees.Machine-written summary

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¶