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IDENTIAL FirstBankPR005212 EFTA 0012869? EFTA01272118 THIS FORM IS PROVIDED TO HELP YOU BALANCE YOUR STATEMENT TO VERIFY YOUR CHECKBOOK BALANCE WI TH THE ENDING BALANCE OF THIS STATEMENT. FOLLOW THESE INSTRUCTIONS S ADO (+) Devoot» nil omdeed by Ilro Bank $ °EDUCT (-) Clara Outstanding S B

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