EFTA00272943
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EFTA00272943
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2
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EFTA00272943.pdf
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Page 1 - EFTA00272943_001
lipStearaMe•LOSISMatellFat01.1WRIMemea....0...11 7457 REQUIRO SCIENTIA LLC FIFTH THIRD BANK PALM BEACH. FL 33483 639171/670 08128/17 PAY TO THE ORDER OF—BlUe Cross alue_Shiele $ "1,040.88 _One Thnlicand Fnrty and RR /1 00************•••••••••• ••••• •••*******••••••••• ••••••••••••••• My I AR$ Blue Cross Blue Shield PO Box 538660 Atlanta, GA 30353-8660 =-'''''''. =S I..Nraoriagasseacesrasscr=en MEMO I 8 Is EFTA00272943
Page 2 - EFTA00272943_002
CREDIT ACCT OF NAMED NeeEEIMI NOORSE NT GU RANTEEDBY BB&T CHARLOTTE NC EFTA00272944
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