STATEMENT DATE 01/09/2012 magic. 1 AMT. ONE MOM ranter 30.00 ACCT NO. 053177 =I= A Ct REOUESTED Office PhoneMM. MAKE CHECK PAYABLE TO: N Y NEUROLOGICAL ASSOCIATES,. ,,,,, Irlitilli 003372 0.5380 AT 0.365 JEFFREY EPSTEIN 9 E 71ST STREET NEW YORK, NY 10021.4102 AMOUNT ENCLOSED: ATTENTION GHI INSUREDS ONLY: