CHECK NUMBER CHECK DATE

1529226 06/06/2024
Banner Life Insurance Company
Attention: Retirement Services
3275 Bennett Creek Avenue
BANNER LIFE | WILLIAM PENN Frederick, Maryland 21704-7608 WELLSFARGO BANK, NA ___
11-24
SAN FRANCISCO, CA 94163 1210

CHECK AMOUNT
PAY NINE THOUSAND THREE HUNDRED TWENTY FIVE DOLLARS AND 87/100**************
**********9,325.87

TO THE ORDER OF: CANDACE N JACOBS

451 CO RD
HANCEVILLE AL 35077
____________________________
AUTHORIZED SIGNATURE
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05/21/2024 500009575

Pay To: ANDREW ABBOTT

2900 Purcell Street
Brighton, CO 80601

Pay From: Community Care Center of Salem, Inc

7611 State Line Road #301
Kansas City MO 64114

MEMO: **1.00