EFTA Document EFTA01582667

Posting Date: Amount: Capture Source: DB/CR: Sequence Number: UDK: Application Code: IRD: Entry Number: Cost Center: Teller Sequence Number: 2012-08-06 Account Number: $15,131.38 Bank Number: 802 PV Check/Serial #: 000000025295 Debit Routing Transit Number: 02100002 6370589004 Trancode: 000000 802120806006370589004 Missing Image: 5 1 Item Type: PE Indicator: BOFD: Teller Number: Processing Date: 2012-08-06 0000004829 Paper Item P 000000000 PAY TO THE ORDER OF NES, LLC 9 EAST 71ST STREET NEW YORK, NY 10021 United- HealthCare t,- JPMORGAN PRIVATE BANK NEWARK, DE 1-2/210 -Fifteen-Thousand One Hundred-Thirty-One and 381100 MEMO: United HealthCare Insurance Company Dept. CH 10151 Palatine, IL 60055-0151 Account # 25295 7/31/2012 $ .*15,131.38 II*0 2 29 S II' I:0 2 L0000 2 LI: M3IA aL 37ONV NV it , C1-1OH 0,0 rn 23 O o rO co Z) ti -n 2 rn a) cf) 000d0 0010151 00293 0015 08-06-202 " BNYMELLON CRED TO PAYEE ABS END GUAR DOLLARS AUTHORIZED SIGNATURE • DO NOT WRITE I SIGN I STAMP BELOW THIS LINE 4- x Z Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00062225 EFTA01582667