Preview
FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021
NYSCEF DOC. NO. 12 RECEIVED NYSCEF: 01/05/2023
EXHIBIT “C”
FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021
NYSCEF Merchant
DOC.Statement
NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023
Start Date: 2015-01-07
End Date: 2022-10-19
Merchant Statement of Activity
Health & Wellness Med (ACH)Merchant ID: 263342
28423 Orchard Lake Road Ste From:
2952015-01-07 - 2022-10-19
Framington Hills, MI 48334
Date Amount Note Type Subtype Contract ID
Balance
2016-04-07
$199.00Payment from 4/7/2016 returned due to R08: Payment Stopped or Stop Payment on Item
Contract ACH Debit 787412
$21,151.00
2016-04-07
$35.00 Returned ACH - Payment Stopped - Payment from 4/7/2016 Fee Charge Returned ACH - Payment Stopped
787412
$20,952.00
2016-04-07
($199.00)
Payment from Daily ACH Debit initiated 2016-04-04 Contract ACH Debit 787412
$20,917.00
2016-04-06
$199.00Payment from 4/6/2016 returned due to R08: Payment Stopped or Stop Payment on Item
Contract ACH Debit 787412
$21,116.00
2016-04-06
$35.00 Returned ACH - Payment Stopped - Payment from 4/6/2016 Fee Charge Returned ACH - Payment Stopped
787412
$20,917.00
2016-04-06
($199.00)
Payment from Daily ACH Debit initiated 2016-04-01 Contract ACH Debit 787412
$20,882.00
2016-04-05
$199.00Payment from 4/5/2016 returned due to R08: Payment Stopped or Stop Payment on Item
Contract ACH Debit 787412
$21,081.00
2016-04-05
$35.00 Returned ACH - Payment Stopped - Payment from 4/5/2016 Fee Charge Returned ACH - Payment Stopped
787412
$20,882.00
2016-04-05
($199.00)
Payment from Daily ACH Debit initiated 2016-03-31 Contract ACH Debit 787412
$20,847.00
2016-04-04
$199.00Payment from 4/4/2016 returned due to R08: Payment Stopped or Stop Payment on Item
Contract ACH Debit 787412
$21,046.00
2016-04-04
$35.00 Returned ACH - Payment Stopped - Payment from 4/4/2016 Fee Charge Returned ACH - Payment Stopped
787412
$20,847.00
2016-04-04
($199.00)
Payment from Daily ACH Debit initiated 2016-03-30 Contract ACH Debit 787412
$20,812.00
2016-04-01
$199.00Payment from 4/1/2016 returned due to R08: Payment Stopped or Stop Payment on Item
Contract ACH Debit 787412
$21,011.00
2016-04-01
$35.00 Returned ACH - Payment Stopped - Payment from 4/1/2016 Fee Charge Returned ACH - Payment Stopped
787412
$20,812.00
2016-04-01
($199.00)
Payment from Daily ACH Debit initiated 2016-03-29 Contract ACH Debit 787412
$20,777.00
2016-03-31
($199.00)
Payment from Daily ACH Debit initiated 2016-03-28 Contract ACH Debit 787412
$20,976.00
2016-03-30
($199.00)
Payment from Daily ACH Debit initiated 2016-03-25 Contract ACH Debit 787412
$21,175.00
2016-03-29
($199.00)
Payment from Daily ACH Debit initiated 2016-03-24 Contract ACH Debit 787412
$21,374.00
2016-03-28
($199.00)
Payment from Daily ACH Debit initiated 2016-03-23 Contract ACH Debit 787412
$21,573.00
2016-03-25
($199.00)
Payment from Daily ACH Debit initiated 2016-03-22 Contract ACH Debit 787412
$21,772.00
2016-03-24
($199.00)
Payment from Daily ACH Debit initiated 2016-03-21 Contract ACH Debit 787412
$21,971.00
2016-03-23
($199.00)
Payment from Daily ACH Debit initiated 2016-03-18 Contract ACH Debit 787412
$22,170.00
2016-03-22
($199.00)
Payment from Daily ACH Debit initiated 2016-03-17 Contract ACH Debit 787412
$22,369.00
2016-03-21
($199.00)
Payment from Daily ACH Debit initiated 2016-03-16 Contract ACH Debit 787412
$22,568.00
2016-03-18
($199.00)
Payment from Daily ACH Debit initiated 2016-03-15 Contract ACH Debit 787412
$22,767.00
2016-03-17
($199.00)
Payment from Daily ACH Debit initiated 2016-03-14 Contract ACH Debit 787412
$22,966.00
2016-03-16
($199.00)
Payment from Daily ACH Debit initiated 2016-03-11 Contract ACH Debit 787412
$23,165.00
2016-03-15
($199.00)
Payment from Daily ACH Debit initiated 2016-03-10 Contract ACH Debit 787412
$23,364.00
2016-03-14
($199.00)
Payment from Daily ACH Debit initiated 2016-03-09 Contract ACH Debit 787412
$23,563.00
2016-03-11
($199.00)
Payment from Daily ACH Debit initiated 2016-03-08 Contract ACH Debit 787412
$23,762.00
2016-03-10
($199.00)
Payment from Daily ACH Debit initiated 2016-03-07 Contract ACH Debit 787412
$23,961.00
2016-03-09
($199.00)
Payment from Daily ACH Debit initiated 2016-03-04 Contract ACH Debit 787412
$24,160.00
2016-03-08
($199.00)
Payment from Daily ACH Debit initiated 2016-03-03 Contract ACH Debit 787412
$24,359.00
2016-03-07
($199.00)
Payment from Daily ACH Debit initiated 2016-03-02 Contract ACH Debit 787412
$24,558.00
2016-03-04
($199.00)
Payment from Daily ACH Debit initiated 2016-03-01 Contract ACH Debit 787412
$24,757.00
2016-03-03
($199.00)
Payment from Daily ACH Debit initiated 2016-02-29 Contract ACH Debit 787412
$24,956.00
2016-03-02
($398.00)
Payment from Daily ACH Debit initiated 2016-02-26 Contract ACH Debit 787412
$25,155.00
2016-03-02
($199.00)
Payment from Daily ACH Debit initiated 2016-02-25 Contract ACH Debit 787412
$25,553.00
2016-03-01
($199.00)
Payment from Daily ACH Debit initiated 2016-02-24 Contract ACH Debit 787412
$25,752.00
2016-02-29
($164.00)
Payment from Daily ACH Debit initiated 2016-02-23 Contract ACH Debit 787412
$25,951.00
2016-02-29
($35.00)
Returned ACH Debit Fee due to NSF Fee Payment Returned ACH - NSF
787412
$26,115.00
2016-02-24
$199.00Returned due to R01: Insufficient Funds Contract ACH Debit 787412
$26,150.00
2016-02-24
$35.00 Returned ACH Debit Fee due to NSF Fee Charge Returned ACH - NSF
787412
$25,951.00
2016-02-23
($199.00)
Payment from Daily ACH Debit initiated 2016-02-22 Contract ACH Debit 787412
$25,916.00
2016-02-22
($199.00)
Payment from Daily ACH Debit initiated 2016-02-19 Contract ACH Debit 787412
$26,115.00
2016-02-19
($199.00)
Payment from Daily ACH Debit initiated 2016-02-18 Contract ACH Debit 787412
$26,314.00
2016-02-18
($199.00)
Payment from Daily ACH Debit initiated 2016-02-17 Contract ACH Debit 787412
$26,513.00
2016-02-17
($199.00)
Payment from Daily ACH Debit initiated 2016-02-16 Contract ACH Debit 787412
$26,712.00
2016-02-16
($199.00)
Payment from Daily ACH Debit initiated 2016-02-12 Contract ACH Debit 787412
$26,911.00
2016-02-12
($199.00)
Payment from Daily ACH Debit initiated 2016-02-11 Contract ACH Debit 787412
$27,110.00
2016-02-11
($199.00)
Payment from Daily ACH Debit initiated 2016-02-10 Contract ACH Debit 787412
$27,309.00
2016-02-10
($199.00)
Payment from Daily ACH Debit initiated 2016-02-09 Contract ACH Debit 787412
$27,508.00
2016-02-09
($199.00)
Payment from Daily ACH Debit initiated 2016-02-08 Contract ACH Debit 787412
$27,707.00
2016-02-08
($199.00)
Payment from Daily ACH Debit initiated 2016-02-05 Contract ACH Debit 787412
$27,906.00
2016-02-05
($199.00)
Payment from Daily ACH Debit initiated 2016-02-04 Contract ACH Debit 787412
$28,105.00
2016-02-04
($199.00)
Payment from Daily ACH Debit initiated 2016-02-03 Contract ACH Debit 787412
$28,304.00
KAPITUS Page 1
FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021
NYSCEF Merchant
DOC.Statement
NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023
Start Date: 2015-01-07
End Date: 2022-10-19
2016-02-03
($199.00)
Payment from Daily ACH Debit initiated 2016-02-02 Contract ACH Debit 787412
$28,503.00
2016-02-02
($199.00)
Payment from Daily ACH Debit initiated 2016-02-01 Contract ACH Debit 787412
$28,702.00
2016-02-01
($199.00)
Payment from Daily ACH Debit initiated 2016-01-29 Contract ACH Debit 787412
$28,901.00
2016-01-29
($199.00)
Payment from Daily ACH Debit initiated 2016-01-28 Contract ACH Debit 787412
$29,100.00
2016-01-28
($199.00)
Payment from Daily ACH Debit initiated 2016-01-27 Contract ACH Debit 787412
$29,299.00
2016-01-27
($199.00)
Payment from Daily ACH Debit initiated 2016-01-26 Contract ACH Debit 787412
$29,498.00
2016-01-26
($199.00)
Payment from Daily ACH Debit initiated 2016-01-25 Contract ACH Debit 787412
$29,697.00
2016-01-25
($199.00)
Payment from Daily ACH Debit initiated 2016-01-22 Contract ACH Debit 787412
$29,896.00
2016-01-22
($199.00)
Payment from Daily ACH Debit initiated 2016-01-21 Contract ACH Debit 787412
$30,095.00
2016-01-21
($199.00)
Payment from Daily ACH Debit initiated 2016-01-20 Contract ACH Debit 787412
$30,294.00
2016-01-20
($199.00)
Payment from Daily ACH Debit initiated 2016-01-19 Contract ACH Debit 787412
$30,493.00
2016-01-19
($199.00)
Payment from Daily ACH Debit initiated 2016-01-15 Contract ACH Debit 787412
$30,692.00
2016-01-15
($199.00)
Payment from Daily ACH Debit initiated 2016-01-14 Contract ACH Debit 787412
$30,891.00
2016-01-14
($199.00)
Payment from Daily ACH Debit initiated 2016-01-13 Contract ACH Debit 787412
$31,090.00
2016-01-13
($199.00)
Payment from Daily ACH Debit initiated 2016-01-12 Contract ACH Debit 787412
$31,289.00
2016-01-12
($199.00)
Payment from Daily ACH Debit initiated 2016-01-11 Contract ACH Debit 787412
$31,488.00
2016-01-12
($199.00)
Payment from Daily ACH Debit initiated 2016-01-08 Contract ACH Debit 787412
$31,687.00
2016-01-08
($199.00)
Payment from Daily ACH Debit initiated 2016-01-07 Contract ACH Debit 787412
$31,886.00
2016-01-07
($199.00)
Payment from Daily ACH Debit initiated 2016-01-06 Contract ACH Debit 787412
$32,085.00
2016-01-06
($199.00)
Payment from Daily ACH Debit initiated 2016-01-05 Contract ACH Debit 787412
$32,284.00
2016-01-05
($199.00)
Payment from Daily ACH Debit initiated 2016-01-04 Contract ACH Debit 787412
$32,483.00
2016-01-04
($199.00)
Payment from Daily ACH Debit initiated 2015-12-31 Contract ACH Debit 787412
$32,682.00
2015-12-31
($199.00)
Payment from Daily ACH Debit initiated 2015-12-30 Contract ACH Debit 787412
$32,881.00
2015-12-30
($199.00)
Payment from Daily ACH Debit initiated 2015-12-29 Contract ACH Debit 787412
$33,080.00
2015-12-29
($199.00)
Payment from Daily ACH Debit initiated 2015-12-28 Contract ACH Debit 787412
$33,279.00
2015-12-28
($199.00)
Payment from Daily ACH Debit initiated 2015-12-24 Contract ACH Debit 787412
$33,478.00
2015-12-24
($199.00)
Payment from Daily ACH Debit initiated 2015-12-23 Contract ACH Debit 787412
$33,677.00
2015-12-23
($199.00)
Payment from Daily ACH Debit initiated 2015-12-22 Contract ACH Debit 787412
$33,876.00
2015-12-22
($199.00)
Payment from Daily ACH Debit initiated 2015-12-21 Contract ACH Debit 787412
$34,075.00
2015-12-21
($199.00)
Payment from Daily ACH Debit initiated 2015-12-18 Contract ACH Debit 787412
$34,274.00
2015-12-18
($199.00)
Payment from Daily ACH Debit initiated 2015-12-17 Contract ACH Debit 787412
$34,473.00
2015-12-17
($199.00)
Payment from Daily ACH Debit initiated 2015-12-16 Contract ACH Debit 787412
$34,672.00
2015-12-16
($199.00)
Payment from Daily ACH Debit initiated 2015-12-15 Contract ACH Debit 787412
$34,871.00
2015-12-15
($199.00)
Payment from Daily ACH Debit initiated 2015-12-14 Contract ACH Debit 787412
$35,070.00
2015-12-14
($199.00)
Payment from Daily ACH Debit initiated 2015-12-11 Contract ACH Debit 787412
$35,269.00
2015-12-11
($199.00)
Payment from Daily ACH Debit initiated 2015-12-10 Contract ACH Debit 787412
$35,468.00
2015-12-10
($199.00)
Payment from Daily ACH Debit initiated 2015-12-09 Contract ACH Debit 787412
$35,667.00
2015-12-09
($199.00)
Payment from Daily ACH Debit initiated 2015-12-08 Contract ACH Debit 787412
$35,866.00
2015-12-08
($199.00)
Payment from Daily ACH Debit initiated 2015-12-07 Contract ACH Debit 787412
$36,065.00
2015-12-07
($199.00)
Payment from Daily ACH Debit initiated 2015-12-04 Contract ACH Debit 787412
$36,264.00
2015-12-04
($199.00)
Payment from Daily ACH Debit initiated 2015-12-03 Contract ACH Debit 787412
$36,463.00
2015-12-03
($199.00)
Payment from Daily ACH Debit initiated 2015-12-02 Contract ACH Debit 787412
$36,662.00
2015-12-02
($199.00)
Payment from Daily ACH Debit initiated 2015-12-01 Contract ACH Debit 787412
$36,861.00
2015-12-01
($199.00)
Payment from Daily ACH Debit initiated 2015-11-30 Contract ACH Debit 787412
$37,060.00
2015-11-30
($199.00)
Payment from Daily ACH Debit initiated 2015-11-27 Contract ACH Debit 787412
$37,259.00
2015-11-27
($199.00)
Payment from Daily ACH Debit initiated 2015-11-25 Contract ACH Debit 787412
$37,458.00
2015-11-25
($199.00)
Payment from Daily ACH Debit initiated 2015-11-24 Contract ACH Debit 787412
$37,657.00
2015-11-24
($199.00)
Payment from Daily ACH Debit initiated 2015-11-23 Contract ACH Debit 787412
$37,856.00
2015-11-23
($199.00)
Payment from Daily ACH Debit initiated 2015-11-20 Contract ACH Debit 787412
$38,055.00
2015-11-20
($199.00)
Payment from Daily ACH Debit initiated 2015-11-19 Contract ACH Debit 787412
$38,254.00
2015-11-19
($199.00)
Payment from Daily ACH Debit initiated 2015-11-18 Contract ACH Debit 787412
$38,453.00
2015-11-18
($199.00)
Payment from Daily ACH Debit initiated 2015-11-17 Contract ACH Debit 787412
$38,652.00
2015-11-17
($199.00)
Payment from Daily ACH Debit initiated 2015-11-16 Contract ACH Debit 787412
$38,851.00
2015-11-16
($13,136.00)
Transfer to new contract Contract Transfer 571392
$39,050.00
2015-11-16
($395.00)
ACH Debit Fee Fee Payment ACH Debit Fee (FUNDING) 787412
$52,186.00
2015-11-16
($15.00)
Funding ACH Fee Fee Payment Funding ACH Fee (FUNDING)787412
$52,581.00
2015-11-16
($395.00)
Origination Fee Fee Payment Origination Fee (FUNDING) 787412
$52,596.00
2015-11-16
$39,050.00
Health & Wellness Med (ACH) Renewal Cash Advance Other via ACH Funding 787412
$52,991.00
2015-11-16
$395.00ACH Debit Fee Fee Charge ACH Debit Fee (FUNDING) 787412
$13,941.00
2015-11-16
$15.00 Funding ACH Fee Fee Charge Funding ACH Fee (FUNDING)787412
$13,546.00
2015-11-16
$395.00Origination Fee Fee Charge Origination Fee (FUNDING) 787412
$13,531.00
2015-11-16
($159.00)
Payment from Daily ACH Debit initiated 2015-11-13 Contract ACH Debit 571392
$13,136.00
2015-11-13
($159.00)
Payment from Daily ACH Debit initiated 2015-11-12 Contract ACH Debit 571392
$13,295.00
2015-11-12
($159.00)
Payment from Daily ACH Debit initiated 2015-11-10 Contract ACH Debit 571392
$13,454.00
2015-11-10
($159.00)
Payment from Daily ACH Debit initiated 2015-11-09 Contract ACH Debit 571392
$13,613.00
2015-11-09
($159.00)
Payment from Daily ACH Debit initiated 2015-11-06 Contract ACH Debit 571392
$13,772.00
2015-11-06
($159.00)
Payment from Daily ACH Debit initiated 2015-11-05 Contract ACH Debit 571392
$13,931.00
2015-11-05
($159.00)
Payment from Daily ACH Debit initiated 2015-11-04 Contract ACH Debit 571392
$14,090.00
2015-11-04
($159.00)
Payment from Daily ACH Debit initiated 2015-11-03 Contract ACH Debit 571392
$14,249.00
2015-11-03
($159.00)
Payment from Daily ACH Debit initiated 2015-11-02 Contract ACH Debit 571392
$14,408.00
2015-11-02
($159.00)
Payment from Daily ACH Debit initiated 2015-10-30 Contract ACH Debit 571392
$14,567.00
KAPITUS Page 2
FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021
NYSCEF Merchant
DOC.Statement
NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023
Start Date: 2015-01-07
End Date: 2022-10-19
2015-10-30
($159.00)
Payment from Daily ACH Debit initiated 2015-10-29 Contract ACH Debit 571392
$14,726.00
2015-10-29
($159.00)
Payment from Daily ACH Debit initiated 2015-10-28 Contract ACH Debit 571392
$14,885.00
2015-10-28
($159.00)
Payment from Daily ACH Debit initiated 2015-10-27 Contract ACH Debit 571392
$15,044.00
2015-10-27
($159.00)
Payment from Daily ACH Debit initiated 2015-10-26 Contract ACH Debit 571392
$15,203.00
2015-10-26
($159.00)
Payment from Daily ACH Debit initiated 2015-10-23 Contract ACH Debit 571392
$15,362.00
2015-10-23
($159.00)
Payment from Daily ACH Debit initiated 2015-10-22 Contract ACH Debit 571392
$15,521.00
2015-10-22
($159.00)
Payment from Daily ACH Debit initiated 2015-10-21 Contract ACH Debit 571392
$15,680.00
2015-10-21
($159.00)
Payment from Daily ACH Debit initiated 2015-10-20 Contract ACH Debit 571392
$15,839.00
2015-10-20
($159.00)
Payment from Daily ACH Debit initiated 2015-10-19 Contract ACH Debit 571392
$15,998.00
2015-10-19
($159.00)
Payment from Daily ACH Debit initiated 2015-10-16 Contract ACH Debit 571392
$16,157.00
2015-10-16
($159.00)
Payment from Daily ACH Debit initiated 2015-10-15 Contract ACH Debit 571392
$16,316.00
Preview
FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021 NYSCEF DOC. NO. 12 RECEIVED NYSCEF: 01/05/2023 EXHIBIT “C” FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021 NYSCEF Merchant DOC.Statement NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023 Start Date: 2015-01-07 End Date: 2022-10-19 Merchant Statement of Activity Health & Wellness Med (ACH)Merchant ID: 263342 28423 Orchard Lake Road Ste From: 2952015-01-07 - 2022-10-19 Framington Hills, MI 48334 Date Amount Note Type Subtype Contract ID Balance 2016-04-07 $199.00Payment from 4/7/2016 returned due to R08: Payment Stopped or Stop Payment on Item Contract ACH Debit 787412 $21,151.00 2016-04-07 $35.00 Returned ACH - Payment Stopped - Payment from 4/7/2016 Fee Charge Returned ACH - Payment Stopped 787412 $20,952.00 2016-04-07 ($199.00) Payment from Daily ACH Debit initiated 2016-04-04 Contract ACH Debit 787412 $20,917.00 2016-04-06 $199.00Payment from 4/6/2016 returned due to R08: Payment Stopped or Stop Payment on Item Contract ACH Debit 787412 $21,116.00 2016-04-06 $35.00 Returned ACH - Payment Stopped - Payment from 4/6/2016 Fee Charge Returned ACH - Payment Stopped 787412 $20,917.00 2016-04-06 ($199.00) Payment from Daily ACH Debit initiated 2016-04-01 Contract ACH Debit 787412 $20,882.00 2016-04-05 $199.00Payment from 4/5/2016 returned due to R08: Payment Stopped or Stop Payment on Item Contract ACH Debit 787412 $21,081.00 2016-04-05 $35.00 Returned ACH - Payment Stopped - Payment from 4/5/2016 Fee Charge Returned ACH - Payment Stopped 787412 $20,882.00 2016-04-05 ($199.00) Payment from Daily ACH Debit initiated 2016-03-31 Contract ACH Debit 787412 $20,847.00 2016-04-04 $199.00Payment from 4/4/2016 returned due to R08: Payment Stopped or Stop Payment on Item Contract ACH Debit 787412 $21,046.00 2016-04-04 $35.00 Returned ACH - Payment Stopped - Payment from 4/4/2016 Fee Charge Returned ACH - Payment Stopped 787412 $20,847.00 2016-04-04 ($199.00) Payment from Daily ACH Debit initiated 2016-03-30 Contract ACH Debit 787412 $20,812.00 2016-04-01 $199.00Payment from 4/1/2016 returned due to R08: Payment Stopped or Stop Payment on Item Contract ACH Debit 787412 $21,011.00 2016-04-01 $35.00 Returned ACH - Payment Stopped - Payment from 4/1/2016 Fee Charge Returned ACH - Payment Stopped 787412 $20,812.00 2016-04-01 ($199.00) Payment from Daily ACH Debit initiated 2016-03-29 Contract ACH Debit 787412 $20,777.00 2016-03-31 ($199.00) Payment from Daily ACH Debit initiated 2016-03-28 Contract ACH Debit 787412 $20,976.00 2016-03-30 ($199.00) Payment from Daily ACH Debit initiated 2016-03-25 Contract ACH Debit 787412 $21,175.00 2016-03-29 ($199.00) Payment from Daily ACH Debit initiated 2016-03-24 Contract ACH Debit 787412 $21,374.00 2016-03-28 ($199.00) Payment from Daily ACH Debit initiated 2016-03-23 Contract ACH Debit 787412 $21,573.00 2016-03-25 ($199.00) Payment from Daily ACH Debit initiated 2016-03-22 Contract ACH Debit 787412 $21,772.00 2016-03-24 ($199.00) Payment from Daily ACH Debit initiated 2016-03-21 Contract ACH Debit 787412 $21,971.00 2016-03-23 ($199.00) Payment from Daily ACH Debit initiated 2016-03-18 Contract ACH Debit 787412 $22,170.00 2016-03-22 ($199.00) Payment from Daily ACH Debit initiated 2016-03-17 Contract ACH Debit 787412 $22,369.00 2016-03-21 ($199.00) Payment from Daily ACH Debit initiated 2016-03-16 Contract ACH Debit 787412 $22,568.00 2016-03-18 ($199.00) Payment from Daily ACH Debit initiated 2016-03-15 Contract ACH Debit 787412 $22,767.00 2016-03-17 ($199.00) Payment from Daily ACH Debit initiated 2016-03-14 Contract ACH Debit 787412 $22,966.00 2016-03-16 ($199.00) Payment from Daily ACH Debit initiated 2016-03-11 Contract ACH Debit 787412 $23,165.00 2016-03-15 ($199.00) Payment from Daily ACH Debit initiated 2016-03-10 Contract ACH Debit 787412 $23,364.00 2016-03-14 ($199.00) Payment from Daily ACH Debit initiated 2016-03-09 Contract ACH Debit 787412 $23,563.00 2016-03-11 ($199.00) Payment from Daily ACH Debit initiated 2016-03-08 Contract ACH Debit 787412 $23,762.00 2016-03-10 ($199.00) Payment from Daily ACH Debit initiated 2016-03-07 Contract ACH Debit 787412 $23,961.00 2016-03-09 ($199.00) Payment from Daily ACH Debit initiated 2016-03-04 Contract ACH Debit 787412 $24,160.00 2016-03-08 ($199.00) Payment from Daily ACH Debit initiated 2016-03-03 Contract ACH Debit 787412 $24,359.00 2016-03-07 ($199.00) Payment from Daily ACH Debit initiated 2016-03-02 Contract ACH Debit 787412 $24,558.00 2016-03-04 ($199.00) Payment from Daily ACH Debit initiated 2016-03-01 Contract ACH Debit 787412 $24,757.00 2016-03-03 ($199.00) Payment from Daily ACH Debit initiated 2016-02-29 Contract ACH Debit 787412 $24,956.00 2016-03-02 ($398.00) Payment from Daily ACH Debit initiated 2016-02-26 Contract ACH Debit 787412 $25,155.00 2016-03-02 ($199.00) Payment from Daily ACH Debit initiated 2016-02-25 Contract ACH Debit 787412 $25,553.00 2016-03-01 ($199.00) Payment from Daily ACH Debit initiated 2016-02-24 Contract ACH Debit 787412 $25,752.00 2016-02-29 ($164.00) Payment from Daily ACH Debit initiated 2016-02-23 Contract ACH Debit 787412 $25,951.00 2016-02-29 ($35.00) Returned ACH Debit Fee due to NSF Fee Payment Returned ACH - NSF 787412 $26,115.00 2016-02-24 $199.00Returned due to R01: Insufficient Funds Contract ACH Debit 787412 $26,150.00 2016-02-24 $35.00 Returned ACH Debit Fee due to NSF Fee Charge Returned ACH - NSF 787412 $25,951.00 2016-02-23 ($199.00) Payment from Daily ACH Debit initiated 2016-02-22 Contract ACH Debit 787412 $25,916.00 2016-02-22 ($199.00) Payment from Daily ACH Debit initiated 2016-02-19 Contract ACH Debit 787412 $26,115.00 2016-02-19 ($199.00) Payment from Daily ACH Debit initiated 2016-02-18 Contract ACH Debit 787412 $26,314.00 2016-02-18 ($199.00) Payment from Daily ACH Debit initiated 2016-02-17 Contract ACH Debit 787412 $26,513.00 2016-02-17 ($199.00) Payment from Daily ACH Debit initiated 2016-02-16 Contract ACH Debit 787412 $26,712.00 2016-02-16 ($199.00) Payment from Daily ACH Debit initiated 2016-02-12 Contract ACH Debit 787412 $26,911.00 2016-02-12 ($199.00) Payment from Daily ACH Debit initiated 2016-02-11 Contract ACH Debit 787412 $27,110.00 2016-02-11 ($199.00) Payment from Daily ACH Debit initiated 2016-02-10 Contract ACH Debit 787412 $27,309.00 2016-02-10 ($199.00) Payment from Daily ACH Debit initiated 2016-02-09 Contract ACH Debit 787412 $27,508.00 2016-02-09 ($199.00) Payment from Daily ACH Debit initiated 2016-02-08 Contract ACH Debit 787412 $27,707.00 2016-02-08 ($199.00) Payment from Daily ACH Debit initiated 2016-02-05 Contract ACH Debit 787412 $27,906.00 2016-02-05 ($199.00) Payment from Daily ACH Debit initiated 2016-02-04 Contract ACH Debit 787412 $28,105.00 2016-02-04 ($199.00) Payment from Daily ACH Debit initiated 2016-02-03 Contract ACH Debit 787412 $28,304.00 KAPITUS Page 1 FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021 NYSCEF Merchant DOC.Statement NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023 Start Date: 2015-01-07 End Date: 2022-10-19 2016-02-03 ($199.00) Payment from Daily ACH Debit initiated 2016-02-02 Contract ACH Debit 787412 $28,503.00 2016-02-02 ($199.00) Payment from Daily ACH Debit initiated 2016-02-01 Contract ACH Debit 787412 $28,702.00 2016-02-01 ($199.00) Payment from Daily ACH Debit initiated 2016-01-29 Contract ACH Debit 787412 $28,901.00 2016-01-29 ($199.00) Payment from Daily ACH Debit initiated 2016-01-28 Contract ACH Debit 787412 $29,100.00 2016-01-28 ($199.00) Payment from Daily ACH Debit initiated 2016-01-27 Contract ACH Debit 787412 $29,299.00 2016-01-27 ($199.00) Payment from Daily ACH Debit initiated 2016-01-26 Contract ACH Debit 787412 $29,498.00 2016-01-26 ($199.00) Payment from Daily ACH Debit initiated 2016-01-25 Contract ACH Debit 787412 $29,697.00 2016-01-25 ($199.00) Payment from Daily ACH Debit initiated 2016-01-22 Contract ACH Debit 787412 $29,896.00 2016-01-22 ($199.00) Payment from Daily ACH Debit initiated 2016-01-21 Contract ACH Debit 787412 $30,095.00 2016-01-21 ($199.00) Payment from Daily ACH Debit initiated 2016-01-20 Contract ACH Debit 787412 $30,294.00 2016-01-20 ($199.00) Payment from Daily ACH Debit initiated 2016-01-19 Contract ACH Debit 787412 $30,493.00 2016-01-19 ($199.00) Payment from Daily ACH Debit initiated 2016-01-15 Contract ACH Debit 787412 $30,692.00 2016-01-15 ($199.00) Payment from Daily ACH Debit initiated 2016-01-14 Contract ACH Debit 787412 $30,891.00 2016-01-14 ($199.00) Payment from Daily ACH Debit initiated 2016-01-13 Contract ACH Debit 787412 $31,090.00 2016-01-13 ($199.00) Payment from Daily ACH Debit initiated 2016-01-12 Contract ACH Debit 787412 $31,289.00 2016-01-12 ($199.00) Payment from Daily ACH Debit initiated 2016-01-11 Contract ACH Debit 787412 $31,488.00 2016-01-12 ($199.00) Payment from Daily ACH Debit initiated 2016-01-08 Contract ACH Debit 787412 $31,687.00 2016-01-08 ($199.00) Payment from Daily ACH Debit initiated 2016-01-07 Contract ACH Debit 787412 $31,886.00 2016-01-07 ($199.00) Payment from Daily ACH Debit initiated 2016-01-06 Contract ACH Debit 787412 $32,085.00 2016-01-06 ($199.00) Payment from Daily ACH Debit initiated 2016-01-05 Contract ACH Debit 787412 $32,284.00 2016-01-05 ($199.00) Payment from Daily ACH Debit initiated 2016-01-04 Contract ACH Debit 787412 $32,483.00 2016-01-04 ($199.00) Payment from Daily ACH Debit initiated 2015-12-31 Contract ACH Debit 787412 $32,682.00 2015-12-31 ($199.00) Payment from Daily ACH Debit initiated 2015-12-30 Contract ACH Debit 787412 $32,881.00 2015-12-30 ($199.00) Payment from Daily ACH Debit initiated 2015-12-29 Contract ACH Debit 787412 $33,080.00 2015-12-29 ($199.00) Payment from Daily ACH Debit initiated 2015-12-28 Contract ACH Debit 787412 $33,279.00 2015-12-28 ($199.00) Payment from Daily ACH Debit initiated 2015-12-24 Contract ACH Debit 787412 $33,478.00 2015-12-24 ($199.00) Payment from Daily ACH Debit initiated 2015-12-23 Contract ACH Debit 787412 $33,677.00 2015-12-23 ($199.00) Payment from Daily ACH Debit initiated 2015-12-22 Contract ACH Debit 787412 $33,876.00 2015-12-22 ($199.00) Payment from Daily ACH Debit initiated 2015-12-21 Contract ACH Debit 787412 $34,075.00 2015-12-21 ($199.00) Payment from Daily ACH Debit initiated 2015-12-18 Contract ACH Debit 787412 $34,274.00 2015-12-18 ($199.00) Payment from Daily ACH Debit initiated 2015-12-17 Contract ACH Debit 787412 $34,473.00 2015-12-17 ($199.00) Payment from Daily ACH Debit initiated 2015-12-16 Contract ACH Debit 787412 $34,672.00 2015-12-16 ($199.00) Payment from Daily ACH Debit initiated 2015-12-15 Contract ACH Debit 787412 $34,871.00 2015-12-15 ($199.00) Payment from Daily ACH Debit initiated 2015-12-14 Contract ACH Debit 787412 $35,070.00 2015-12-14 ($199.00) Payment from Daily ACH Debit initiated 2015-12-11 Contract ACH Debit 787412 $35,269.00 2015-12-11 ($199.00) Payment from Daily ACH Debit initiated 2015-12-10 Contract ACH Debit 787412 $35,468.00 2015-12-10 ($199.00) Payment from Daily ACH Debit initiated 2015-12-09 Contract ACH Debit 787412 $35,667.00 2015-12-09 ($199.00) Payment from Daily ACH Debit initiated 2015-12-08 Contract ACH Debit 787412 $35,866.00 2015-12-08 ($199.00) Payment from Daily ACH Debit initiated 2015-12-07 Contract ACH Debit 787412 $36,065.00 2015-12-07 ($199.00) Payment from Daily ACH Debit initiated 2015-12-04 Contract ACH Debit 787412 $36,264.00 2015-12-04 ($199.00) Payment from Daily ACH Debit initiated 2015-12-03 Contract ACH Debit 787412 $36,463.00 2015-12-03 ($199.00) Payment from Daily ACH Debit initiated 2015-12-02 Contract ACH Debit 787412 $36,662.00 2015-12-02 ($199.00) Payment from Daily ACH Debit initiated 2015-12-01 Contract ACH Debit 787412 $36,861.00 2015-12-01 ($199.00) Payment from Daily ACH Debit initiated 2015-11-30 Contract ACH Debit 787412 $37,060.00 2015-11-30 ($199.00) Payment from Daily ACH Debit initiated 2015-11-27 Contract ACH Debit 787412 $37,259.00 2015-11-27 ($199.00) Payment from Daily ACH Debit initiated 2015-11-25 Contract ACH Debit 787412 $37,458.00 2015-11-25 ($199.00) Payment from Daily ACH Debit initiated 2015-11-24 Contract ACH Debit 787412 $37,657.00 2015-11-24 ($199.00) Payment from Daily ACH Debit initiated 2015-11-23 Contract ACH Debit 787412 $37,856.00 2015-11-23 ($199.00) Payment from Daily ACH Debit initiated 2015-11-20 Contract ACH Debit 787412 $38,055.00 2015-11-20 ($199.00) Payment from Daily ACH Debit initiated 2015-11-19 Contract ACH Debit 787412 $38,254.00 2015-11-19 ($199.00) Payment from Daily ACH Debit initiated 2015-11-18 Contract ACH Debit 787412 $38,453.00 2015-11-18 ($199.00) Payment from Daily ACH Debit initiated 2015-11-17 Contract ACH Debit 787412 $38,652.00 2015-11-17 ($199.00) Payment from Daily ACH Debit initiated 2015-11-16 Contract ACH Debit 787412 $38,851.00 2015-11-16 ($13,136.00) Transfer to new contract Contract Transfer 571392 $39,050.00 2015-11-16 ($395.00) ACH Debit Fee Fee Payment ACH Debit Fee (FUNDING) 787412 $52,186.00 2015-11-16 ($15.00) Funding ACH Fee Fee Payment Funding ACH Fee (FUNDING)787412 $52,581.00 2015-11-16 ($395.00) Origination Fee Fee Payment Origination Fee (FUNDING) 787412 $52,596.00 2015-11-16 $39,050.00 Health & Wellness Med (ACH) Renewal Cash Advance Other via ACH Funding 787412 $52,991.00 2015-11-16 $395.00ACH Debit Fee Fee Charge ACH Debit Fee (FUNDING) 787412 $13,941.00 2015-11-16 $15.00 Funding ACH Fee Fee Charge Funding ACH Fee (FUNDING)787412 $13,546.00 2015-11-16 $395.00Origination Fee Fee Charge Origination Fee (FUNDING) 787412 $13,531.00 2015-11-16 ($159.00) Payment from Daily ACH Debit initiated 2015-11-13 Contract ACH Debit 571392 $13,136.00 2015-11-13 ($159.00) Payment from Daily ACH Debit initiated 2015-11-12 Contract ACH Debit 571392 $13,295.00 2015-11-12 ($159.00) Payment from Daily ACH Debit initiated 2015-11-10 Contract ACH Debit 571392 $13,454.00 2015-11-10 ($159.00) Payment from Daily ACH Debit initiated 2015-11-09 Contract ACH Debit 571392 $13,613.00 2015-11-09 ($159.00) Payment from Daily ACH Debit initiated 2015-11-06 Contract ACH Debit 571392 $13,772.00 2015-11-06 ($159.00) Payment from Daily ACH Debit initiated 2015-11-05 Contract ACH Debit 571392 $13,931.00 2015-11-05 ($159.00) Payment from Daily ACH Debit initiated 2015-11-04 Contract ACH Debit 571392 $14,090.00 2015-11-04 ($159.00) Payment from Daily ACH Debit initiated 2015-11-03 Contract ACH Debit 571392 $14,249.00 2015-11-03 ($159.00) Payment from Daily ACH Debit initiated 2015-11-02 Contract ACH Debit 571392 $14,408.00 2015-11-02 ($159.00) Payment from Daily ACH Debit initiated 2015-10-30 Contract ACH Debit 571392 $14,567.00 KAPITUS Page 2 FILED: NEW YORK COUNTY CLERK 01/05/2023 11:34 AM INDEX NO. 656887/2021 NYSCEF Merchant DOC.Statement NO. 12 Health Wellness Med (ACH) RECEIVED NYSCEF: 01/05/2023 Start Date: 2015-01-07 End Date: 2022-10-19 2015-10-30 ($159.00) Payment from Daily ACH Debit initiated 2015-10-29 Contract ACH Debit 571392 $14,726.00 2015-10-29 ($159.00) Payment from Daily ACH Debit initiated 2015-10-28 Contract ACH Debit 571392 $14,885.00 2015-10-28 ($159.00) Payment from Daily ACH Debit initiated 2015-10-27 Contract ACH Debit 571392 $15,044.00 2015-10-27 ($159.00) Payment from Daily ACH Debit initiated 2015-10-26 Contract ACH Debit 571392 $15,203.00 2015-10-26 ($159.00) Payment from Daily ACH Debit initiated 2015-10-23 Contract ACH Debit 571392 $15,362.00 2015-10-23 ($159.00) Payment from Daily ACH Debit initiated 2015-10-22 Contract ACH Debit 571392 $15,521.00 2015-10-22 ($159.00) Payment from Daily ACH Debit initiated 2015-10-21 Contract ACH Debit 571392 $15,680.00 2015-10-21 ($159.00) Payment from Daily ACH Debit initiated 2015-10-20 Contract ACH Debit 571392 $15,839.00 2015-10-20 ($159.00) Payment from Daily ACH Debit initiated 2015-10-19 Contract ACH Debit 571392 $15,998.00 2015-10-19 ($159.00) Payment from Daily ACH Debit initiated 2015-10-16 Contract ACH Debit 571392 $16,157.00 2015-10-16 ($159.00) Payment from Daily ACH Debit initiated 2015-10-15 Contract ACH Debit 571392 $16,316.00