) this period I yeas-to-date Total Overdraft Fee(s) $20.00 $100 DD Total Retooled Item Fee(s) $29.00 $29.0D YES or the DIV StattPDOOlpenocs mar begos m storyor0AV, yd., RANKAATE I NAME (FIRST 1 ADDRESS INO. STREET) CHANGE OF ADDRESS PLEASE PRINT. USE BLUE OR BLACK BALL POINT PEN. MI LAST ACCOUNT NUMBERS