A (US) O Swift O Other Intermidary Bank Account/Code: Intermediary Bank Name: Other Payment Details (Reference/ Advice Description/Addenda) Relmb. medical tudhottred By 10/11/13 Date ID: 036310114004156 DATE 1011/2013 20 3100 Page 3 of 3 DID: 8887316607 CSID: iNDEXt: INDEX2 Confidential Tr