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DENTIAL FirstBankPR002988 EFTA (()126468 EFTA01270768 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 ADO (*k Dopos4s not omdeed by lbo Bank $ °EDUCT (-) Check; Outstanding 5 BALA

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