7006 REQUIRO SCIENTIA LLC PALM BLAQI, ft 33490 63 9171 670 FIFTH THIRD BANK PAY TOME °Rom or Moo rrncc Blue Shield Twn Thnutand Two Hundred Eleven and 79/100******"*""n********" Blue Cross Blue Shield PO Box 538660 Atlanta, GA 30353-8660 MEMO at 05/21/15 $ "2.211/9 I DOLLARS 8 n'007006fil I:067090 L 9i: 74338123231P EFTA00272581 CREDIT ACCT OF NAMED PAYEE 0005211513537 0 ENDORSEMENT GUARANTEED BY BB/1T CHARLOTTE NC - - - - >9501011-214 -10901539 002211:79 009 ( EFTA00272582