u3C4:-Q2 L CONFIDENTIAL FiristBankPRO04740 EFTA JX1128220 EFTA01670521 THIS FORM IS PROVIDED TO HELP YOU BALANCE YOUR STATEMENT TO VERIFY YOUR CTIECKBOOK BALANCE WM THE ENONG BALANCE OF TIPS STATEMENT FOLLOW TI IESE INSTRUCTIONS DEPOSITS NOT CREDITED BY TIE BANK $ Apo ree vorke t ,' Et. 5 DATE