EFTA Document EFTA01582668

Posting Date: 2012-08-07 Account Number: Amount: $1,586.40 Bank Number: 802 Capture Source: PV Check/Serial #: 000000025294 DB/CR: Debit Routing Transit Number: 02100002 Sequence Number: 5070182412 Trancode: UDK: 802120807005070182412 Missing Image: 5 Application Code: 1 Item Type: Paper Item IRD: PE Indicator: Entry Number: 0000002341 BOFD: Cost Center: Teller Number: Teller Sequence Number: Processing Date: 2012-08-07 NES, Lie 9 EAST 71ST STREET ' ;:' NEW YORK, NY 10021 PAY TO THE ORDER OF Aetna Health Inc. --One-Thousand-Eive_Hundrecl_Eighty.Six_ancl_40/100 Aetna Health Inc. PO Box 0824 Carol Stream, IL 60132-0824 MEMO: Account JPMORGAN PRIVATE BANK NEWARK, DE 1-2/21O $ ..1,586.40 Ittr* ******* DOLLARS "0252940 I:021,000021cl L AUTyIOPoZED SIGNATURE 2 'woo L 58 6 40, - P M31A 01 373NV NV IV G701-1 z 0 cit O C) O rn 0 O -< S O O P08521417 FOR >0311013209< - DEPOSIT CITIBANK., N. A. n 1.4! k.) NFL! r.re.::T! rn--11' 98249266 066 080512 09824 15 DO NOT WRITE / SIGN / STAMP BELOW THIS LINE x 2 Confidential Treatment Requested by JPMorgan Chase JPM-SDNY-00082228 EFTA01582668