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The document is a bank statement for an account holder with two accounts, a regular share account and a checking account. It shows transactions and balances for both accounts for the statement period. At the bottom it includes sections for draft reconciliation and reporting electronic transfer errors.
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0% found this document useful (0 votes)
85 views

Document 3

The document is a bank statement for an account holder with two accounts, a regular share account and a checking account. It shows transactions and balances for both accounts for the statement period. At the bottom it includes sections for draft reconciliation and reporting electronic transfer errors.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Statement of Account
215 Centerview Drive
Building 3, Suite 111 Member No. Statement Ending Date Page
Brentwood, TN 37027 14131 10/31/22 1 of 5
www.koincu.org
ACCOUNT SUMMARY
01 00 Regular Share Acct $ 5.00
07 00 Simplify Chk Act $ 874.02

98

ROBERT HEGEDUS
1818 CHURCH ST APT 201
NASHVILLE, TN 37203

Regular Share Acct 01 00


YTD Federal
Beginning Balance Deposits / Credits Withdrawals / Debits Ending Balance YTD Dividends
Withholding
$ 5.00 $ 100.00 $ 100.00 $ 5.00 $ 0.00 $ 0.00
Transaction Effective
Date Date Transaction Description Deposit Withdrawal Balance
09/30/22 Balance Forward $ 5.00
10/13/22 10/13/22 Deposit Internet From Online Banking Transfer from 1413107 00 to account $ 100.00 $ 105.00
1413101 00 for $100.0
10/23/22 10/23/22 Withdrawal Internet To Online Banking Transfer from 1413101 00 to account $ 95.00 $ 10.00
1413107 00 for $95.0
10/28/22 10/28/22 Withdrawal Internet To Online Banking Transfer from 1413101 00 to account $ 5.00 $ 5.00
1413107 00 for $5.0

Simplify Chk Act 07 00


YTD Federal
Beginning Balance Deposits / Credits Withdrawals / Debits Ending Balance
Withholding
$ 386.48 $ 5,205.79 $ 4,718.25 $ 874.02 $ 0.00
Transaction Effective
Date Date Transaction Description Deposit Withdrawal Balance
09/30/22 Balance Forward $ 386.48
10/01/22 10/01/22 Withdrawal SIG Trnsctn 10/01 - CHEWYCOM - CHEWY.COM 800-672-4399 FL $ 45.81 $ 340.67
10/01/22 10/01/22 Withdrawal SIG Trnsctn 09/30 - STARBUCKS STORE 55082 - STARBUCKS STORE $ 9.31 $ 331.36
55082 COUNCIL BLUFF IA
10/01/22 10/02/22 Withdrawal SIG Trnsctn 10/01 - PRICELN*BEST WESTERN P - PRICELN*BEST $ 218.88 $ 112.48
WESTERN P 800-774-2354 CT
10/02/22 10/02/22 Withdrawal SIG Trnsctn 09/30 - HARRAHS RESORT F/D - HARRAHS RESORT F/D $ 54.14 $ 58.34
COUNCIL BLUFF IA
10/04/22 10/04/22 Withdrawal SIG Trnsctn 10/04 - VISIBLE - VISIBLE 866-331-3527 CO $ 25.00 $ 33.34
10/06/22 10/06/22 Withdrawal SIG Trnsctn 10/05 - JERSEY MIKES 25008 - JERSEY MIKES 25008 ST $ 24.83 $ 8.51
PERES MO
10/06/22 10/06/22 Deposit ACH HORTON GROUP LLC PAYROLL $ 999.00 $ 1,007.51
10/06/22 10/07/22 Withdrawal POS Trnsctn 10/06 - HOBBYLOBBY - 1113 MURFREESBORO RD SU $ 24.66 $ 982.85
FRANKLIN TN
SHARE DRAFT RECONCILEMENT THIS FORM IS PROVIDED TO ASSIST YOU IN BALANCING YOUR DRAFT ACCOUNT

LIST DRAFTS OUTSTANDING NOT CHARGED TO MY DRAFT ACCOUNT PERIOD ENDING

DRAFT NUMBER AMOUNT DRAFT NUMBER AMOUNT

1) I SUBTRACT FROM MY DRAFT REGISTER ANY CHARGES LISTED ON THIS DRAFT


STATEMENT WHICH YOU HAVE NOT PREVIOUSLY DEDUCTED FROM MY
BALANCE. ALSO, ADD ANY DIVIDEND.

2) ENTER DRAFT BALANCE SHOWN


ON THIS STATEMENT HERE

3) ENTER DEPOSITS MADE LATER


THAN THE ENDING DATE ON
THIS STATEMENT

TOTAL
(2 PLUS 3)

4) IN MY DRAFT REGISTER CHECK-OFF ALL DRAFTS PAID


AND, IN AREA PROVIDED AT LEFT, LIST NUMBERS AND
AMOUNTS OF ALL UNPAID DRAFTS

5) SUBTRACT TOTAL DRAFTS


OUSTANDING

6) THIS AMOUNT SHOULD EQUAL MY


TOTAL DRAFT REGISTER BALANCE.

IF I DO NOT BALANCE
VERIFY ADDITIONS AND SUBTRACTIONS ABOVE AND IN MY DRAFT REGISTER
COMPARE THE DOLLAR AMOUNTS OF DRAFTS LISTED ON THIS STATEMENT WITH THE DRAFT
AMOUNTS LISTED IN MY DRAFT REGISTER
COMPARE THE DOLLAR AMOUNTS OF DEPOSITS LISTED ON THIS STATEMENT WITH THE DEPOSIT
AMOUNTS RECORDED IN MY DRAFT REGISTER.

IN CASE OF ERRORS OR QUESTIONS ABOUT MY ELECTRONIC TRANSFERS


I will telephone you at (800) 833-6805 or write to you at 215 Centerview Drive, Building 3, Suite 111 Brentwood, TN 37027 as soon as I can if I think my statement or receipt is wrong or if
I need more information about a transfer listed on the statement or receipt. You must hear from me no later than 60 days after you send the FIRST statement on which the error or problem appeared.
1) I’ll tell you my name and account number.
2) I’ll describe the error or transfer I am unsure about and explain as clearly as I can why I believe it is an error or why need more information.
3) I’ll tell you the dollar amount of the suspected error.
You will investigate my complaint and will correct any error promptly. If you take more than 10 business days to do this, you will recredit my account for the amount I think is in error so that I
will have the use of the money during the time it takes you to complete your investigation.
PERIDODIC STATEMENT DISCLOSURES FOR OPEN END LOANS
PERIODIC RATE: The periodic rate used in calculating the FINANCE CHARGE is the daily periodic rate (shown on the reverse) ANNUAL PERCENTAGE RATE (shown on the reverse).
WHEN PERIODIC FINANCE CHARGE IS IMPOSED: The periodic FINANCE CHARGE begins on the date each advance is posted to my account.
HOW YOU DETERMINE THE BALANCE UPON WHICH MY PERIODIC FINANCE CHARGE IS COMPUTED: To get the unpaid balance you will take the amount of the loan outstanding and
unpaid after each transaction. That gives you the unpaid balance.
HOW YOU DETERMINE MY TOTAL PERIODIC FINANCE CHARGE. Each time I make a payment on my account (or from the date of my first advance on a new account), you will multiply the
unpaid balance by the daily periodic rate (see reverse), and multiply that result by the number of days since the date of the last payment (or from the date of my first advance on a new account).
When advances are added to the loan, the periodic FINANCE CHARGE is computed on the unpaid balance from the date of the past payment (or from the date of my first advance on a new
account) to the date of the additional advance, then on the total unpaid balance to the date of the next payment. This determines my total FINANCE CHARGE for the billing cycle.
A minus(-) figure in the periodic FINANCE CHARGE column on the reverse indicates a credit of a periodic FINANCE CHARGE to my account
A “closing date” on the reverse indicates the closing date of my billing cycle.
The periodic rate and the ANNUAL PERCENTAGE rate is subject to change on loans marked “variable” on the reverse.
MY BILLING RIGHTS FOR OPEN-END LOANS — KEEP THIS NOTICE FOR FUTURE USE
This notice contains important information about my rights and your responsibilities under the Fair Credit Billing Act.
NOTIFICATION IN CASE OF ERRORS OR QUESTIONS ABOUT MY STATEMENT
If I think my statement is wrong, or if I need more information about a transaction on my statement, I must write to you on a separate sheet at the address listed on my statement. I should write to you as
soon as possible. You must hear from me no later than 60 days after you sent me the first statement on which the error or problem appeared. I can telephone you, but doing so will not preserve my rights.
In my letter, I should give you the following information:
• My name and account number.
• The dollar amount of the suspected error.
• Describe the error and explain, if I can, why I believe this is an error. If I need more information, describe the item I am not sure about.
If I have authorized you to make my credit card statement automatically from my Share or Share Draft account, I can stop the payment on any amount I think is wrong. To stop the payment
my letter must reach us three business days before the automatic payment is scheduled to occur.
MY RIGHTS AND YOUR RESPONSIBILITIES AFTER YOU RECEIVE MY WRITTEN NOTICE
You must acknowledge my letter within 30 days, unless you have corrected the error by then. Within 90 days, you must either correct the error or explain why you believe the statement was correct.
After you receive my letter, you cannot try to collect any amount I question, or report me as delinquent. You can continue to bill me for the amount you question, including FINANCE
CHARGE and you can apply any unpaid amount against my credit limit. I do not have to pay any questioned amount while you are investigating, but I am still obligated to pay the
parts of the statement that are not in question.
If you find that we made a mistake on my statement, I will not have to pay any FINANCE CHARGES related to any questioned amount. If you did not make a mistake, I may have to pay FINANCE
CHARGES, and I will have to make up any missed payments on the questioned amount. In either case, you will send me a statement of the amount I owe and the date that it is due.
If I fail to pay the amount that you think I owe, you may report me as delinquent. However, if your explanation does not satisfy me and I write us within ten days telling you that I still refuse to
pay, you must tell anyone you report me to that I have a question about my statement. And you must tell me the name of anyone you reported me to. You must tell anyone you report me to
that the matter has been settled between us when it finally is.
If you don’t follow these rules, you can’t collect the first $50.00 of the questioned amount, even if my statement was correct.
3
Tray2

Member Number Statement Ending Date Page


215 Centerview Drive
14131 10/31/22 2 of 5
Building 3, Suite 111
Brentwood, TN 37027
www.koincu.org

Simplify Chk Act 07 00 (continued)


Transaction Effective
Date Date Transaction Description Deposit Withdrawal Balance
10/06/22 10/07/22 Withdrawal SIG Trnsctn 10/06 - SQ *OLD SCHOOL SALES 3 - SQUARE PURCHASE $ 26.32 $ 956.53
FRANKLIN TN
10/06/22 10/07/22 Withdrawal POS Trnsctn 10/06 - WALGREENS STORE 3901 HILL - WALGREENS $ 23.15 $ 933.38
STORE 3901 HI NASHVILLE TN
10/07/22 10/07/22 Withdrawal SIG Trnsctn 10/06 - HOPDODDY - NASHVILLE BELC - HOPDODDY - $ 66.64 $ 866.74
NASHVILLE BE NASHVILLE TN
10/07/22 10/07/22 Withdrawal SIG Trnsctn 10/07 - CIRCLE K # 03701 - CIRCLE K # 03701 SMYRNA $ 32.09 $ 834.65
TN
10/07/22 10/08/22 Withdrawal SIG Trnsctn 10/07 - CONTACT LENS KING INC - CONTACT LENS KING $ 35.39 $ 799.26
INC. 800-352-0255 NY
10/07/22 10/08/22 Withdrawal SIG Trnsctn 10/07 - PRICELN*CLARION INN MU - PRICELN*CLARION $ 171.56 $ 627.70
INN MU 800-774-2354 CT
10/08/22 10/09/22 Withdrawal POS Trnsctn 10/08 - NNT COMMUNITY VAPOR002484 - 2466 $ 20.83 $ 606.87
OLDFORT PKWY MURFREESBORO TN
10/08/22 10/09/22 Withdrawal POS Trnsctn 10/08 - Speedway - 108 Battalion Blvd Murfreesboro TN $ 1.51 $ 605.36
10/08/22 10/09/22 Withdrawal POS Trnsctn 10/08 - Speedway - 108 Battalion Blvd Murfreesboro TN $ 8.77 $ 596.59
10/09/22 10/09/22 Withdrawal SIG Trnsctn 10/08 - BASKIN #362265 - BASKIN #362265 $ 15.84 $ 580.75
MURFREESBORO TN
10/09/22 10/09/22 Withdrawal SIG Trnsctn 10/08 - JETS PIZZA TN-004 - JETS PIZZA TN-004 $ 25.23 $ 555.52
MURFREESBORO TN
10/09/22 10/10/22 Withdrawal POS Trnsctn 10/09 - CRACKER BARREL #90 M BORO - 138 CHAFFIN $ 37.17 $ 518.35
PL MURFREESBORO TN
10/09/22 10/10/22 Withdrawal SIG Trnsctn 10/09 - PRICELN*CLARION INN MU - PRICELN*CLARION $ 74.97 $ 443.38
INN MU 800-774-2354 CT
10/11/22 10/11/22 Withdrawal SIG Trnsctn 10/11 - TUSCULUM STRIKE & SPARE - TUSCULUM $ 21.85 $ 421.53
STRIKE & SPARE NASHVILLE TN
10/11/22 10/11/22 Withdrawal SIG Trnsctn 10/10 - MCDONALD'S F10244 - MCDONALD'S F10244 $ 11.48 $ 410.05
MURFREESBORO TN
10/11/22 10/12/22 Withdrawal POS Trnsctn 10/11 - NNT SMOKE TOKEN 002840 - 409 HARDING $ 13.95 $ 396.10
PLACE NASHVILLE TN
10/13/22 10/13/22 Deposit ACH HORTON GROUP LLC PAYROLL $ 999.00 $ 1,395.10
10/13/22 10/13/22 Withdrawal Internet To Online Banking Transfer from 1406207 00 to account $ 100.00 $ 1,295.10
1406201 00 for $100.0
10/13/22 10/14/22 Withdrawal POS Trnsctn 10/13 - NNT SMYRNA BOWLING 000589 - 95 WEAKLEY $ 6.00 $ 1,289.10
LANE SMYRNA TN
10/13/22 10/14/22 Withdrawal POS Trnsctn 10/13 - NNT SMYRNA BOWLING 002552 - 95 WEAKLEY $ 8.00 $ 1,281.10
LANE SMYRNA TN
10/13/22 10/14/22 Withdrawal POS Trnsctn 10/13 - LOVEBOUND MURFREESBORO - LOVEBOUND $ 71.29 $ 1,209.81
MURFREESBORO MURFREESBORO TN
10/14/22 10/14/22 Withdrawal SIG Trnsctn 10/13 - RECREATIONGOV - RECREATION.GOV $ 60.00 $ 1,149.81
877-444-6777 NM
10/14/22 10/14/22 Withdrawal SIG Trnsctn 10/13 - STEAK-N-SHAKE#0380 Q99 - $ 15.11 $ 1,134.70
STEAK-N-SHAKE#0380 Q99 MURFREESBORO TN
10/14/22 10/15/22 Withdrawal POS Trnsctn 10/14 - WM SUPERCENTER #682 - Wal-Mart Super Center $ 109.33 $ 1,025.37
MURFREESBORO TN
10/15/22 10/15/22 Withdrawal SIG Trnsctn 10/14 - PRICELN*CLARION INN MU - PRICELN*CLARION $ 160.56 $ 864.81
INN MU 800-774-2354 CT
10/15/22 10/15/22 Withdrawal SIG Trnsctn 10/14 - DOMINO'S 6308 - DOMINO'S 6308 615-890-2315 TN $ 30.42 $ 834.39

10/15/22 10/15/22 Withdrawal POS Trnsctn 10/15 - AUTOZONE 3885 2720 OLD F - AUTOZONE 3885 $ 31.79 $ 802.60
2720 OLD MURFREESBORO TN
10/15/22 10/15/22 Withdrawal SIG Trnsctn 10/15 - 7-ELEVEN 41070 - 7070 US HIGHWAY 70 SOUT $ 20.00 $ 782.60
NASHVILLE TN
10/15/22 10/15/22 Withdrawal POS Trnsctn 10/15 - CVS/PHARMACY #06398 - 06398--7112 HIGHWAY $ 4.58 $ 778.02
70 NASHVILLE TN
10/15/22 10/16/22 Withdrawal POS Trnsctn 10/15 - HOBBYLOBBY 1789B GALLATIN - HOBBYLOBBY $ 10.34 $ 767.68
1789B GALLAT MADISON TN
10/15/22 10/16/22 Withdrawal ATM Trnsctn 10/15 - RACETRAC PETROLEUM - 1804 GALLATIN PIKE $ 103.00 $ 664.68
N MURFREESBORO TN
10/16/22 10/16/22 Withdrawal SIG Trnsctn 10/15 - POPEYES 8215 - POPEYES 8215 MADISON TN $ 9.49 $ 655.19
10/16/22 10/16/22 Withdrawal SIG Trnsctn 10/14 - LOS BARRILES INC - LOS BARRILES INC $ 27.68 $ 627.51
MURFREESBORO TN
10/16/22 10/16/22 Withdrawal SIG Trnsctn 10/15 - STEAK-N-SHAKE#0313 Q99 - $ 5.94 $ 621.57
STEAK-N-SHAKE#0313 Q99 MADISON TN
10/16/22 10/17/22 Withdrawal POS Trnsctn 10/16 - DOLLAR-GENERAL #2004 - DG 020048 MAIN ST E $ 15.31 $ 606.26
GORDONSVILLE TN
10/16/22 10/17/22 Withdrawal POS Trnsctn 10/16 - DOLLAR-GENERAL #2004 - DG 020048 MAIN ST E $ 5.03 $ 601.23
GORDONSVILLE TN
10/16/22 10/17/22 Withdrawal SIG Trnsctn 10/15 - CLARION INN - CLARION INN 6158962420 TN $ 47.90 $ 553.33
Member Number Statement Ending Date Page
14131 10/31/22 3 of 5

Simplify Chk Act 07 00 (continued)


Transaction Effective
Date Date Transaction Description Deposit Withdrawal Balance
10/16/22 10/17/22 Withdrawal SIG Trnsctn 10/15 - BIG ROCK MARKET - BIG ROCK MARKET SILVER $ 25.93 $ 527.40
POINT TN
10/17/22 10/17/22 Withdrawal SIG Trnsctn 10/16 - MCDONALD'S F18322 - MCDONALD'S F18322 $ 14.44 $ 512.96
GORDONSVILLE TN
10/17/22 10/17/22 Withdrawal SIG Trnsctn 10/17 - SHELL SERVICE STATION - SHELL SERVICE $ 20.00 $ 492.96
STATION GORDONSVILLE TN
10/18/22 10/18/22 Withdrawal SIG Trnsctn 10/17 - MCDONALD'S F18322 - MCDONALD'S F18322 $ 3.38 $ 489.58
GORDONSVILLE TN
10/18/22 10/18/22 Withdrawal SIG Trnsctn 10/17 - DOMINO'S 5456 - DOMINO'S 5456 210-590-1437 TN $ 32.46 $ 457.12

10/18/22 10/18/22 Withdrawal SIG Trnsctn 10/17 - TACO BELL #004386 - TACO BELL #004386 $ 13.75 $ 443.37
BRENTWOOD TN
10/18/22 10/19/22 Withdrawal SIG Trnsctn 10/17 - UNIFORM ADVANTAGE - UNIFORM ADVANTAGE $ 32.75 $ 410.62
GOODLETTSVLLE TN
10/19/22 10/19/22 Withdrawal SIG Trnsctn 10/19 - TIL*CE MALIBUJCK LX PO - TIL*CE MALIBUJCK LX $ 23.20 $ 387.42
PO LEXINGTON KY
10/19/22 10/19/22 Withdrawal SIG Trnsctn 10/18 - PRICELN*WINGATE BY WYN - $ 78.57 $ 308.85
PRICELN*WINGATE BY WYN 800-774-2354 CT
10/19/22 10/19/22 Withdrawal SIG Trnsctn 10/18 - AGAVE & RYE LEXINGTON RP - AGAVE & RYE $ 32.42 $ 276.43
LEXINGTON R LEXINGTON KY
10/19/22 10/19/22 Withdrawal SIG Trnsctn 10/19 - HOTWIRE-SALES FINAL - HOTWIRE-SALES FINAL $ 53.28 $ 223.15
866-468-9473 CA
10/19/22 10/19/22 Withdrawal POS Trnsctn 10/19 - AUTOZONE 4592 - 120 SAND LAKE DR $ 7.41 $ 215.74
LEXINGTON KY
10/19/22 10/19/22 Withdrawal SIG Trnsctn 10/19 - FASMART 5262 - 5400 REVILO ROAD US $ 28.37 $ 187.37
WINCHESTER KY
10/19/22 10/20/22 Withdrawal SIG Trnsctn 10/19 - SP HMOA MUSEUM STORE - SP HMOA MUSEUM $ 10.00 $ 177.37
STORE 130-45292701 WV
10/19/22 10/20/22 Withdrawal SIG Trnsctn 10/19 - SP HMOA MUSEUM STORE - SP HMOA MUSEUM $ 10.12 $ 167.25
STORE 130-45292701 WV
10/19/22 10/20/22 Withdrawal SIG Trnsctn 10/18 - MAPCO 3066 - MAPCO 3066 GOODLETTSVILL TN $ 28.41 $ 138.84
10/20/22 10/20/22 Withdrawal SIG Trnsctn 10/19 - MCDONALD'S F11645 - MCDONALD'S F11645 $ 14.38 $ 124.46
CHARLESTON WV
10/20/22 10/20/22 Withdrawal SIG Trnsctn 10/19 - MCDONALD'S F11645 - MCDONALD'S F11645 $ 9.90 $ 114.56
CHARLESTON WV
10/20/22 10/20/22 Withdrawal POS Trnsctn 10/20 - USPS PO 55145807 4600 MAC - USPS PO $ 15.65 $ 98.91
55145807 4600 M CHARLESTON WV
10/20/22 10/20/22 Deposit ACH HORTON GROUP LLC PAYROLL $ 999.00 $ 1,097.91
10/20/22 10/20/22 Withdrawal SIG Trnsctn 10/20 - Speedway - 3451 Charleston Rd Ripley WV $ 34.92 $ 1,062.99
10/20/22 10/21/22 Withdrawal POS Trnsctn 10/20 - 7-ELEVEN - 1360 W CHESTNUT ST US $ 5.66 $ 1,057.33
WASHINGTON PA
10/21/22 10/21/22 Withdrawal SIG Trnsctn 10/20 - PRICELN*DAYS INN BY WY - PRICELN*DAYS INN $ 65.98 $ 991.35
BY WY 800-774-2354 CT
10/21/22 10/21/22 Withdrawal SIG Trnsctn 10/20 - MCDONALD'S F11645 - MCDONALD'S F11645 $ 9.91 $ 981.44
CHARLESTON WV
10/21/22 10/21/22 Withdrawal POS Trnsctn 10/21 - TARGET STORE T-3392 - 482 Smithfield St $ 32.58 $ 948.86
Pittsburgh PA
10/21/22 10/21/22 Withdrawal POS Trnsctn 10/21 - SHEETZ 0360 - SHEETZ 0360 MONROEVILLE PA $ 3.41 $ 945.45
10/21/22 10/21/22 Withdrawal POS Trnsctn 10/21 - 7-ELEVEN - 7910 US ROUTE 30 E US IRWIN PA $ 30.00 $ 915.45
10/21/22 10/22/22 Withdrawal SIG Trnsctn 10/21 - SUNOCO 0079866000 - PINE LANE AND PA $ 25.00 $ 890.45
TURNPI PLAINFIELD PA
10/21/22 10/22/22 Withdrawal SIG Trnsctn 10/21 - CHINATOWN INN - CHINATOWN INN $ 31.29 $ 859.16
PITTSBURGH PA
10/21/22 10/22/22 Withdrawal SIG Trnsctn 10/20 - SARDIS DAIRY BAR - SARDIS DAIRY BAR SARDIS $ 7.00 $ 852.16
OH
10/21/22 10/22/22 Withdrawal SIG Trnsctn 10/21 - PRICELN*EVEN HOTELS PI - PRICELN*EVEN $ 128.07 $ 724.09
HOTELS PI 800-774-2354 CT
10/22/22 10/22/22 Withdrawal SIG Trnsctn 10/21 - STATE PARKS - STATE PARKS ACTIVECOM PA $ 42.50 $ 681.59
10/22/22 10/22/22 Withdrawal SIG Trnsctn 10/21 - EVEN PITTSBURGH - EVEN PITTSBURGH $ 5.14 $ 676.45
PITTSBURGH PA
10/22/22 10/23/22 Withdrawal SIG Trnsctn 10/21 - FORBES GARAGE - FORBES GARAGE $ 34.00 $ 642.45
PITTSBURGH PA
10/23/22 10/23/22 Withdrawal SIG Trnsctn 10/23 - WIX PAYMENTS US - WIX PAYMENTS US $ 10.00 $ 632.45
HTTPSWWWSLOT CA
10/23/22 10/24/22 Withdrawal ATM Trnsctn 10/23 - Harrahs AC - 777 HARRAHS BLVD ATLANTIC CITY $ 406.99 $ 225.46
NJ
10/23/22 10/23/22 Deposit Internet From Online Banking Transfer from 1406201 00 to account $ 95.00 $ 320.46
1406207 00 for $95.0
10/23/22 10/24/22 Withdrawal SIG Trnsctn 10/23 - DOUUGH ACCOUNT FUNDING - DOUUGH $ 108.68 $ 211.78
ACCOUNT FUNDING WWWDOUUGH.CO NY
10/24/22 10/24/22 Withdrawal SIG Trnsctn 10/23 - MCDONALD'S F4595 - MCDONALD'S F4595 $ 11.60 $ 200.18
ABSECON NJ
10/24/22 10/24/22 Deposit ACH HORTON GROUP LLC PAYROLL $ 999.00 $ 1,199.18
5
Tray2

Member Number Statement Ending Date Page


215 Centerview Drive
14131 10/31/22 4 of 5
Building 3, Suite 111
Brentwood, TN 37027
www.koincu.org

Simplify Chk Act 07 00 (continued)


Transaction Effective
Date Date Transaction Description Deposit Withdrawal Balance
10/25/22 10/25/22 Withdrawal SIG Trnsctn 10/24 - MCDONALD'S F6866 - MCDONALD'S F6866 $ 5.09 $ 1,194.09
ATLANTIC CITY NJ
10/25/22 10/25/22 Withdrawal ATM Trnsctn 10/25 - Harrahs AC - 777 HARRAHS BLVD ATLANTIC CITY $ 166.99 $ 1,027.10
NJ
10/25/22 10/25/22 Withdrawal ATM Trnsctn 10/25 - Harrahs AC - 777 HARRAHS BLVD ATLANTIC CITY $ 126.99 $ 900.11
NJ
10/25/22 10/25/22 Withdrawal SIG Trnsctn 10/25 - CASH APP*ROBERT - CASH $ 5.00 $ 895.11
APP*ROBERT 8774174551 CA
10/26/22 10/26/22 Withdrawal SIG Trnsctn 10/26 - DOUUGH ACCOUNT FUNDING - DOUUGH $ 103.50 $ 791.61
ACCOUNT FUNDING WWWDOUUGH.CO NY
10/26/22 10/26/22 Withdrawal SIG Trnsctn 10/26 - LYFT RIDE TUE 5PM - LYFT RIDE TUE 5PM $ 9.43 $ 782.18
855-865-9553 CA
10/26/22 10/26/22 Withdrawal POS Trnsctn 10/26 - WALGREENS STORE 1101 ATLA - WALGREENS $ 16.91 $ 765.27
STORE 1101 AT ATLANTIC CITY NJ
10/27/22 10/27/22 Withdrawal SIG Trnsctn 10/26 - PARKS CAMP DELAWARE INT - PARKS CAMP $ 41.00 $ 724.27
DELAWARE INT DESTATEPARKS DE
10/27/22 10/27/22 Withdrawal SIG Trnsctn 10/26 - WAWA 941 - WAWA 941 MAYS LANDING NJ $ 1.91 $ 722.36
10/27/22 10/27/22 Withdrawal SIG Trnsctn 10/26 - ADVANCE AUTO PARTS #9856 - ADVANCE AUTO $ 16.49 $ 705.87
PARTS #985 PLEASANTVILLE NJ
10/27/22 10/27/22 Deposit SIG Trnsctn 10/27 - APPLE CASH - APPLE CASH Visa Direct CA $ 98.50 $ 804.37
10/27/22 10/27/22 Withdrawal SIG Trnsctn 10/25 - APPLE CASH - APPLE CASH 1INFINITELOOP CA $ 70.00 $ 734.37
10/27/22 10/27/22 Withdrawal SIG Trnsctn 10/26 - HARRAHS DESTINATIONS - HARRAHS $ 20.08 $ 714.29
DESTINATIONS ATLANTIC CITY NJ
10/27/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - CASH APP*ROBERT - CASH $ 70.00 $ 644.29
APP*ROBERT 8774174551 CA
10/27/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - CASH APP*ROBERT - CASH $ 50.00 $ 594.29
APP*ROBERT 8774174551 CA
10/27/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - CASH APP*ROBERT - CASH $ 95.00 $ 499.29
APP*ROBERT 8774174551 CA
10/27/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - SHORE STOP 270 - SHORE STOP 270 MILTON DE $ 24.78 $ 474.51
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - JERSEY MIKES 35001 - JERSEY MIKES 35001 $ 18.49 $ 456.02
REHOBOTH DE
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - MCDONALD'S F6866 - MCDONALD'S F6866 $ 18.62 $ 437.40
ATLANTIC CITY NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - WALGREENS #19860 - WALGREENS #19860 $ 2.97 $ 434.43
ATLANTIC CITY NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - GIFT SHOP 4NJ26 - GIFT SHOP 4NJ26 $ 5.70 $ 428.73
PENNSGROVE NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - ROCKTANE FUEL - ROCKTANE FUEL ATLANTIC $ 20.00 $ 408.73
CITY NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - CINNABON 4NJ26 - CINNABON 4NJ26 $ 11.49 $ 397.24
PENNSGROVE NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - PIZZA HUT 4NJ26 - PIZZA HUT 4NJ26 $ 5.96 $ 391.28
PENNSGROVE NJ
10/28/22 10/28/22 Withdrawal SIG Trnsctn 10/27 - HARRAHS AC HOTEL LODGING - HARRAHS AC $ 264.52 $ 126.76
HOTEL LODGIN ATLANTIC CITY NJ
10/28/22 10/28/22 Withdrawal POS Trnsctn 10/28 - BAKERS EXXON - 17921 COASTAL HWY LEWES $ 6.87 $ 119.89
DE
10/28/22 10/28/22 Deposit Internet From Online Banking Transfer from 1406201 00 to account $ 5.00 $ 124.89
1406207 00 for $5.0
10/28/22 10/29/22 Deposit SIG Trnsctn 10/28 - APPLE CASH - APPLE CASH Visa Direct CA $ 12.29 $ 137.18
10/28/22 10/29/22 Withdrawal POS Trnsctn 10/28 - SHEETZ 0728 - SHEETZ 0728 CHARLOTTESVIL $ 10.00 $ 127.18
VA
10/28/22 10/29/22 Withdrawal SIG Trnsctn 10/28 - APEXMART - 15378 LEE HWY BUCHANAN VA $ 6.35 $ 120.83
10/29/22 10/29/22 Withdrawal SIG Trnsctn 10/28 - NEWGATE AUTO CARE - NEWGATE AUTO CARE $ 9.89 $ 110.94
CENTREVILLE VA
10/29/22 10/29/22 Withdrawal SIG Trnsctn 10/27 - APPLE CASH - APPLE CASH 1INFINITELOOP CA $ 100.00 $ 10.94
10/29/22 10/29/22 Withdrawal SIG Trnsctn 10/28 - APPLE CASH - APPLE CASH 1INFINITELOOP CA $ 10.00 $ 0.94
10/31/22 10/31/22 Deposit ACH HORTON GROUP LLC PAYROLL $ 999.00 $ 999.94
10/31/22 11/01/22 Withdrawal POS Trnsctn 10/31 - WAL Wal-Mart Super 611978 - 0659 WAL-SAMS $ 14.54 $ 985.40
NASHVILLE TN
10/31/22 11/01/22 Withdrawal POS Trnsctn 10/31 - WM SUPERCENTER #5616 - Wal-Mart Super $ 56.74 $ 928.66
Center NASHVILLE TN
10/31/22 11/01/22 Withdrawal POS Trnsctn 10/31 - WM SUPERCENTER #5616 - Wal-Mart Super $ 54.64 $ 874.02
Center NASHVILLE TN
Member Number Statement Ending Date Page
14131 10/31/22 5 of 5

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