OFFICIAL RECORD Endem,IRcLiod6-immi UNCLASSIFIED FEDERAL BUREAU OF INVESTIGATION Import Form Form Type: . _-794 - Payment AuthurizaLLun Form Date: Title: (9) Reimbu

5.39 763.08 -22.31 178.46 -66.50 532.00 this period Year to date -1.20 9.60 NelPay $1,209.06 Earnings Statement Period Starting: Period Endem: Pay Date: Business Phone: 04/03/2017 04/16/2017 04/13/2017 LESLEY K GROFF Deposits account number )00000(3159 transit/ABA XXXXXXXXX You: