Please Type ostrucdors) frafertar flatrala Effective Date: 12/26/12 Pinson enter current or future date only Setae' Appropiate Payment Type and Fie'ds will be Displayed O Principal: Po Takarkillia JPMC Transfer 0 ACM 0 Check $2,145.60 Debit Account it: O Inceme: Domestic Wire Debit Acc