Bishop Statesman Club Lessee LLC, d/b/a Elison Independent Living of Statesman Club v. SHRYL CUDJOE AND CHARIS CUDJOE

IN THE DISTRICT COURT IN AND FOR OKLAHOMA COUNTY STATE OF OKLAHOMA BISHOP STATESMAN CLUB LESSEE ) LLC, DBA ELISON INDEPENDENT ) LIVING OF STATESMAN CLUB ) ) Plaintiff, vs. SHRYL CUDJOE AND ) CHARIS CUDJOE ) an individual, Defendants. Case No. CJ-2026-1387 FILED IN DISTRICT COURT OKLAHOMA COUNTY FEB 23 2026 RICK WARREN COURT CLERK PETITION Plaintiff, Bishop Statesman Club Lessee LLC, d/b/a Elison Independent Living of Statesman Club ("Elison"), for its causes of action against Defendants, Shryl Cudjoe and Charis Cudjoe, alleges and states as follows: PARTIES, JURISDICTION AND VENUE 1. Elison is, and at all pertinent times was, a limited liability company organized and existing under the laws of the State of Oklahoma. 2. Upon information and belief, Shryl Cudjoe is, and at all pertinent times was, a resident of Oklahoma. 3. Upon information and belief, Charis Cudjoe is, and at all pertinent times was, a resident of Oklahoma. 4. Elison hereby disclaims its right to a trial by jury on the claims stated herein. 5. This Court has jurisdiction over the parties, and the subject matter of this action and venue is proper in this Court. GENERAL FACTS 6. Elison operates a residential independent living community in Oklahoma City. 7. On or about November 30, 2022, Elison and Defendants executed a written agreement (the “Lease”) in which Defendants agreed to lease from Elison certain residential property located at 10401 Vineyard Blvd., Apt. 216, in Oklahoma City, Oklahoma 73102 (the “Property”). 8. The lease term commenced on November 30, 2022 and continued on a month to month basis (the “Term”). 9. On August 1, 2025, an amendment to the Lease was executed by Elison and Defendants (the “Amended Lease”). 10. The Lease, as amended, required Defendants to pay Elison rent on a monthly basis in an amount of $2911 during the Term. See Exhibit A. In the event Defendants failed to pay the agreed-upon rent by the date the rent became due and payable, the Lease allowed Elison to charge Defendants a late fee of five percent of the total outstanding balance. As a month-to-month tenant, Defendants were obligated to make rent payments as contemplated by the Lease. 11. Defendants became delinquent in their rental payments to Elison starting in August 2023, making payments less than the total balance. Defendants have failed to complete payments to Elison in satisfaction of the balance since that time, despite Shryl Cudjoe’s continuous possession and use of the Property. 12. On July 31, 2025, Elison mailed, via U.S. Certified Mail, a written 30-day notice of termination of residency to Shryl Cudjoe per 41 O.S. § 111. See Exhibit B. 13. As of the filing of this Petition, Shryl Cudjoe has not vacated the Property and Defendants have not made any payment whatsoever since she made a small payment in August of 2025 that did not satisfy her outstanding balance. FIRST CAUSE OF ACTION – FORCIBLE ENTRY AND DETAINER 14. Elison adopts and restates the allegations contained in the preceding paragraphs. 15. Shryl Cudjoe still resides at 10401 Vineyard Boulevard Apt. 216, Oklahoma City, OK 73120. 16. Charis Cudjoe, per the Lease, guaranteed payment to Elison for the tenancy as a party responsible for Shryl Cudjoe. 17. As of February 1, 2026, Defendants owe Elison $23,396.13 for unpaid rents, including late penalties, under the Lease. See Exhibit C. 18. Elison has made demand upon Defendants for payment of said amount owed under the Lease but Defendants have failed to pay the same. 19. Shryl Cudjoe continues to maintain wrongful possession of the Property. PRAYER FOR RELIEF WHEREFORE, Plaintiff, Bishop Statesman Club Lessee LLC, d/b/a Elison Independent Living of Statesman Club, prays for Judgment in its favor and against Defendants, awarding Plaintiff: (1) immediate possession of the Property; (2) its actual damages as established at trial in an amount equal to $23,396.13 for unpaid rents as of February 1, 2026 plus additional rent accruing at a rate of $2,911 per month from and after February 1, 2026, or a prorated amount thereof; (3) its costs, including attorneys’ fees; (4) pre- and post-judgment interest; and (5) such other and further relief which the Court deems just and proper. Respectfully submitted, CONNER & WINTERS, LLP Hayley N. Stephens, OBA No. 32515 Ashlyn Frix, OBA No. 35605 Michael Albright, OBA No. 36569 CONNER & WINTERS, LLP 4100 First Place Tower 15 East Fifth Street Tulsa, OK 74103 (918) 586-5711 [email protected] [email protected] [email protected] Attorneys for Plaintiff Residency Agreement Elison Independent Living of Statesman Club This Residency Agreement ("Agreement") is made as of this 30th day of November 2022, by and between Bishop Statesman Club Lessee LLC, dba Elison Independent Living of Statesman Club ("Elison of Statesman Club" or "Community"), located at 10401 Vineyard Blvd., Oklahoma City, OK 73120 and Shyrl Cudjoe, hereafter referred to as the "Resident(s)" or "you". If required by Elison of Statesman Club, the person signing this Agreement in the capacity of Responsible Party shall join in this Agreement for the purposes expressed herein. Collectively, Elison of Statesman Club, Resident and, if applicable, Responsible Party, are referred to herein as "the Parties." (If more than one person is signing this Agreement on behalf of Resident, the terms "you" and "Resident" refer to each of you individually and to both of you together.) The Community provides residency and services to qualified seniors. The Community operates on a non-discriminatory basis and affords equal treatment and access to services to all eligible persons. The purpose of this Agreement is to provide a statement of the services furnished to Resident, and the other legal obligations of The Community. The Agreement also sets forth your legal obligations, both financial and non-financial. The terms and conditions of this Agreement are as follows: SECTION 1: SERVICES PROVIDED 1.1 Standard Services: The Monthly Base Fee includes the following services & amenities: a. Meals (See Resident Handbook for specific meal information) b. Unlimited use of designated laundry facilities c. Use of Fitness Center d. Cable television e. Scheduled transportation – Subject to execution of transportation waiver f. Access to Community employees ("Associates") on a 24/7 basis g. Routine repair and maintenance of apartment h. Shared access to all common areas 1.2 Ancillary Services: The Community offers services for additional fees in accordance with Section 2.2(b). a. Beauty and barber services b. Non-routine maintenance services c. Wireless Internet d. Guest meals e. Non-routine carpet cleaning f. Special events or activities g. Transportation services h. Meals delivered 1.3 Notification of Choice of Physician: The Community does not provide medical or nursing care to Residents of its Independent living apartments. While not required, it is recommended that each Resident notify The Community in writing of the name, address, and telephone number of the Resident’s physician, should it be necessary to contact a health care provider regarding Resident’s condition and Resident is unable to initiate such communication. Notwithstanding the foregoing, while The Community may contact Resident’s chosen physician or any other health care provider to provide care for the Resident, The Community is not required to do so, and this provision shall not be construed as creating a legal or contractual obligation on The Community to provide any medical or nursing care, or notification to Resident’s physician. Resident and Responsible Party shall remain financially responsible for any charges for such health care provider or providers and for any charges for transporting Resident to a physician’s office or other medical facility. 1.4 Excluded Services; Third-Party Providers: The Community shall not be responsible for furnishing or paying for any health care items or services not expressly included in this Agreement, including but not limited to, home health, hospice, physicians’ services, nursing services, surgery, hospital care, treatment or examination of eyes or teeth, medications, vitamins, eyeglasses, contact lenses, hearing aids, orthopedic appliances, medical supplies, prosthetic devices, laboratory tests and x-ray services. The Resident and Responsible Party are responsible for obtaining and paying for any services that Resident requires or desires which are not included in the Standard Services or procured Ancillary Services. Any fees for services provided by other service providers will be billed directly by the service provider. All third-party service providers must enter into the form of Third-Party Provider Agreement with The Community attached as Exhibit D. In connection with the engagement of any third party to perform services, Resident agrees to abide by the terms and provisions of the Third-Party Policy attached as Exhibit E. You may not contract with any of the Community’s current Associates to perform any services in the Community. You may contract with former Associates to perform services at the Community only with the Community’s consent. The Community reserves the right to refuse entry to (i) former Associates, (ii) persons whose actions may be disruptive to the Community, (iii) persons whose actions may threaten the safety of any Resident or Associate, or (iv) persons whose presence may foreseeably result in liability to the Community. SECTION 2: PAYMENT FOR SERVICES 2.1 Community Fee: Upon executing this Agreement, Resident will pay a one-time non-refundable Community Fee (the “Community Fee”) in an amount applicable to the type of apartment chosen by the Resident. See Exhibit A for a listing of apartment type(s) and applicable Community Fees. If the Resident currently has a Priority or Wait List Deposit, such funds will be credited toward the Resident’s Community Fee with the balance due upon execution of this Agreement (see Exhibit A). The Community Fee is non-refundable; however, in the event the Resident terminates this Agreement in writing within ten (10) days of execution, five hundred dollars ($500.00) of the Community Fee paid will be returned to the Resident. 2.2 Monthly Fees: The Resident’s Monthly Fee is comprised of the following three (3) components: a. Base Fee: The Base Fee is a monthly fee that is determined by the type of apartment chosen by the Resident (see Exhibit A). The community reserves the right to increase rates for rent or services at any time after providing written thirty- (30) day notice (or such longer notice period as required by state or local law) to the Resident and/or Responsible Party. If the Resident changes apartments, the Base Fee may be immediately adjusted. Changes to the Base Fee will be reflected on the Rental Rate Amendment Form which must be signed by the Resident or Responsible Party. b. Ancillary Service Fees: The Ancillary Service Fee is a monthly fee for optional services that are requested by the Resident or Responsible Party. Such services are offered on an as available basis and billed in accordance with the then current Ancillary Service Fee schedule. (See Exhibit A). c. Second Occupant Fee: The Second Occupant Fee is a monthly fee that applies if a second person is to occupy the apartment. 2.3 Priority Deposit: If a prospective Resident has decided to join the Community but is not ready to occupy an apartment immediately, he or she may reserve an apartment for up to five (5) days by making a five hundred-dollar ($500.00) deposit (the “Priority Deposit”) and completing and signing the Community’s applicable form(s). If the prospective Resident enters into this Agreement within such five (5) day period, the Priority Deposit will be applied to the Community Fee. If the prospective Resident does not enter into this Agreement within such five (5) day period, then, at his or her option, the Priority Deposit will be either (i) applied to a Wait-List Deposit, or (ii) refunded, in which event the parties shall have no further obligations to each other. 2.4 Transfer Fee: The Community charges a Transfer Fee of one thousand dollars ($1,000.00) when a Resident moves from one apartment to another. If Resident alternatively moves or relocates to a different type of apartment, then, in connection with such move, the Resident must pay the difference between the Community Fee associated with the new apartment and the Community Fee that Resident initially paid. The Transfer Fee applies whether moving between apartments of the same type or apartments of differing types. The Community may waive the Transfer Fee if (i) the move is required to make reasonable accommodations as may be necessary to permit a Resident with a disability to obtain equal access to the housing and services offered by The Community, or (ii) the Resident’s level of care increases. SECTION 3: PAYMENT TERMS 3.1 Electronic Debit Authorization: The Community requires that all monthly fees be paid by either (i) automatic electronic bank-account debit pursuant to an ACH Recurring Debit Authorization Form substantially in the form attached as Exhibit E (the “ACH Recurring Debit Authorization Form”), or (ii) credit card. If Resident elects to pay by credit card, Resident shall be responsible for all processing, transaction and/or merchant fees imposed on The Community in connection with such payment. The Credit Card Authorization Form is attached as Exhibit F.. The Monthly Fee is due in advance on the date, which must be no later than the fourth (4th) day of each calendar month. 3.2 Late Payments and Delinquencies: The Resident’s account will be considered past due and a Late Fee equal to 5% of the total Monthly Fees outstanding will be assessed if payment is not received by the fourth (4th) day of the month for any reason. An additional fee of twenty-five dollars ($25.00) will be assessed for any dishonored ACH draft or returned check. If the Community deems it necessary to initiate collection efforts to collect past due or delinquent amounts from the Resident, collection efforts will normally proceed as follows: a. Within five (5) days after the Resident’s account becomes due, The Community will call the Resident or his or her Responsible Party as a reminder of the past due balance. b. If the past due amount is not paid within fifteen (15) days of it becoming due, The Community will send a letter or email message to the Resident or his or her Responsible Party requesting payment of the past due amount. c. If the past due amount is not paid within thirty (30) days of it becoming due, The Community reserves the right to engage a collection agency to collect the past due amount. d. If the past due amount is not paid within thirty (30) days of it becoming due, the Resident may receive notice to vacate his or her apartment. e. The Community reserves the right to revise, modify, amend, or rescind, at any time in its sole discretion, any portion of the process set forth in this Section. SECTION 4: TERM AND TERMINATION 4.1 Term: The term of this Agreement shall be month to month beginning on the earlier of: (i) the date the Resident occupies the apartment, or (ii) the date the Resident begins paying the Monthly Fee; and continues from calendar month to calendar month, unless terminated by Resident or The Community, as provided in this Agreement. The apartment is considered occupied when the Resident’s personal items are placed in the apartment. If the Resident has not occupied the apartment or begun paying the Monthly Fee within thirty (30) days from the effective date of this Agreement, this Agreement will automatically terminate and the Resident and The Community shall have no further obligations under this Agreement. 4.2 Termination: Any Party may terminate this Agreement at any time by giving written notice, thirty (30) days in advance, via Certified Mail, Return Receipt Requested, or delivered directly to the Executive Director of the Community. If the Resident or Responsible Party fails to provide such written notice to The Community, Resident and the Responsible Party will be charged for thirty (30) days at the then current Monthly Fee after the date Resident’s personal belongings are removed from the apartment. In the event of the resident’s death, the resident’s estate (or the person or entity responsible for payment of fees under this agreement) will continue to be responsible for all outstanding fees at the time of resident’s death, and for 30 (thirty) days of rent beginning at the time all personal belongings have been removed from the apartment/cottage. The Resident and Responsible Party will be obligated to pay the full Monthly Fee for the final month. A refund will be issued for any amount due back to the Resident and the Responsible Party pending the final walk-through. 4.3 Termination without Notice: If The Community, in its sole discretion, determines that providing a thirty (30) day notice would be dangerous or detrimental to the health, welfare, safety and/or well-being of the The Community Residents or Associates, The Community may terminate this Agreement without notice and require the Resident to vacate the premises immediately. In such event, the then current Monthly Fee will be pro-rated and remain the responsibility of Resident or Responsible Party. 4.5 Moving Out; Furniture Donations: Upon termination of this Agreement, all of Resident’s belongings must be removed from the apartment and all keys and other The Community-owned property must be returned to The Community. Until Resident’s apartment is vacated and all personal belongings are removed, the Resident, the Resident’s estate, and the Responsible Party shall remain liable for the monthly Base Fee. The Community shall be entitled to remove promptly and store all property from your apartment at your expense not to exceed twenty-five percent (25%) of the Monthly Fee, when you permanently vacate your apartment. We shall give you or your estate fourteen (14) days’ written notice of such removal and shall eventually dispose of your property as provided by law if not claimed. If your property is not claimed within forty-five (45) days following the date of our notice to you or your estate, we may dispose of your property. Residents are not permitted to donate or place furniture in the common areas at any time. 4.6 Deductions: The Community may deduct reasonable charges from the refund amount for (i) all damages to the apartment above and beyond ordinary wear and tear, including any improvements made without the Community’s written consent, (ii) unpaid Monthly Fees, and (iii) unpaid late charges. SECTION 5: MISCELLANEOUS PROVISIONS 5.1 Access to Your Apartment: The Community Associates may enter your apartment to respond to emergencies and to perform services such as housekeeping, inspections, maintenance, repairs, improvements, and other services. Additionally, the Resident agrees to allow any duly authorized agent of any regulatory agency to enter and inspect the Resident’s apartment. Residents are not permitted to use any locking devices on the entry doors to their apartments. The Resident also agrees to allow The Community Associates to show Resident’s apartment with proper notification. If Resident does not wish for his/her apartment to be shown to prospective Residents, Resident may opt-out by providing written notice to The Community. 5.2 Personal Belongings: The Community is not responsible for theft, destruction, or other loss of any property belonging to Residents, guests, visitors, or invitees of Resident. You are responsible for securing your apartment. We strongly recommend that you obtain, at your expense, insurance for the replacement value of your personal property, at adequate coverage and liability limits. 5.3 Background Check: The Community will perform background checks on potential residents for independent living communities although not required by law. 5.4 Religious Affiliation: The Community is not affiliated with any religious organization. 5.5 Advance Directives: You and your Responsible Party acknowledge receiving The Community’s Advance Directive Policies and Procedures. The Community does not require or otherwise mandate its Residents execute advanced directives, but it is The Community’s policy to ask all Residents whether they have executed an advance directive. Such advance directives include: (i) health care powers of attorney; (ii) living wills; (iii) do-not-resuscitate orders, (iv) directives to physicians, and other documents which describe the amount, level, or type of health care the Resident wants to receive if the Resident can no longer communicate those decisions. This information is useful and allows The Community to better serve its Residents. However, the Resident is not required, and may refuse, to provide any information regarding its advanced directives. Should Resident agree to provide this information, and if the Resident has executed an advance directive, or executes, changes, or revokes an advance directive while residing at The Community, the Resident and Responsible Party agree to advise appropriate The Community personnel and to provide The Community with a copy of the advance directive or revocation. Copies of Residents’ advance directives will be made available to health care professionals in emergency situations as directed and authorized by the Resident. The Parties agree that The Community has no responsibility to communicate the end of life preferences expressed by the Resident to anyone, except to release copies of any Advance Directives as requested by, and authorized by, the Resident or the Responsible Party if such person is authorized to receive such information. 5.6 Compliance with Rules and Regulations: Resident and Responsible Party agree to abide by and conform to the rules, regulations and policies for the operation and management of The Community. Resident acknowledges receipt of a copy of the Resident Handbook before execution of this Agreement. 5.7 Visits and Communication. The Community encourages family visits and communication. Visitors are welcome at any time provided that they respect the rights of other residents and staff, and abide by the Guest Policy attached as Exhibit G, including any limitations on the length of stay or frequency of visits. Before any visitor stays in your apartment overnight, you must notify the Executive Director in writing. All visitors must sign in and out at the front desk when entering or leaving the Community. Resident shall be responsible for ensuring that Resident’s guests abide by the Guest Policy and are not disruptive. Resident’s guests may be denied access to The Community and Resident’s residency may be terminated if Resident or his or her guests fail to observe these rules. Your guests may stay with you in your apartment for a maximum of seven (7) consecutive days and fourteen (14) days per calendar year. 5.8 Assignment: This Agreement may not be assigned by Resident or Responsible Party without the prior written consent of The Community. The rights and obligations of The Community may be assigned in whole or in part, to any person or entity, which person or entity shall be responsible for all obligations under this Agreement in full from and after the date Resident is notified of such assignment. The Community may engage another person or entity to perform any or all of the services under this Agreement. All the terms of this Agreement shall be binding upon and inure to the benefit of the heirs, successors, and permitted assigns of the Parties hereto. 5.9 Grievances: The Resident or Responsible Party should report any problem and/or grievance as soon as it arises to allow a prompt resolution. The complaint should be made in writing, if possible, and submitted to any departmental supervisor or the Executive Director. 5.10 Smoking: The Community is a NON-SMOKING community. This applies to residents, Associates, and visitors. 5.11 No Firearms or Other Weapons: To the greatest extent allowed by law, the possession, discharge or use of firearms and other weapons at the Community IS PROHIBITED. This applies to Community Residents, Associates, and visitors. 5.12 Leaving the Community: Residents are free to leave The Community at any time they wish; however, The Community is not responsible for any obligations or expenses incurred at such times. Resident agrees to notify The Community in advance of such departure. The Community is not responsible for the Resident’s health, safety or welfare while Resident is away from the premises or with any person not directly employed by The Community. 5.13 Severability: If any terms or conditions of this Agreement are or become invalid or unenforceable by rule of law, federal or state regulation, or relevant local law, statute or regulation, the remaining provisions of this Agreement shall be construed as if the invalid or unenforceable terms or conditions did not exist and the remainder of the Agreement shall remain in full force and effect. 5.14 Governing Law: This Agreement shall be governed by and construed under the laws of the State of Oklahoma, except the Binding Arbitration provisions, which shall be governed by federal law including the Federal Arbitration Act. 5.15 Exhibits: All Exhibits are incorporated by reference into this Agreement and made a part hereof. 5.16 Entire Agreement: This Agreement, including all Exhibits and addenda attached hereto, constitutes the entire Agreement between the parties with respect to the subject matter hereof, and it supersedes all prior oral or written agreements, commitments, or understandings with respect to the matters provided herein. 5.17 Amendment: This month to month agreement is subject to amendments at the discretion of the community. The community must set forth such amendments or provisions in writing and provide residents/responsible parties at least thirty (30) days written notice prior to any modification. 5.18 Non-Discrimination and Accommodation: The Community does not discriminate on the basis of race, religion, color, national origin, sex, age, disability, marital status, or source of payment. It is the policy of The Community to make reasonable accommodations in its rules, policies and procedures, as necessary to permit a Resident or prospective Resident with a disability to obtain equal access to the housing and services offered by The Community. Requests for reasonable accommodations may be made orally or submitted in writing to The Community. The Community will comply with all applicable state and federal laws regarding the provision of a Resident’s request for reasonable accommodation. The Community recognizes that under certain circumstances a Resident’s pet may be considered a service or emotional support animal, or other similar qualified animal ("Service Animal") under applicable state and federal laws, including but not limited to the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act and other applicable state and federal statutes and/or regulations ("Applicable Law"). Should an animal or pet qualify as a Service Animal under Applicable Law, The Community will make such accommodations and access for such Service Animal as may be required for compliance with Applicable Law. 5.19 Evacuation of the Community: The Community maintains a formal evacuation policy for residents in the event of a natural disaster or other events. Resident agrees to abide by the Evacuation Policy attached as Exhibit H. 5.20 Notices: Notices required by this Agreement shall be in writing and delivered either by hand delivery or mail. If delivered by mail, notices shall be sent via Express Mail or by certified or registered mail, return receipt requested. All notices and other communications required under this Agreement shall be addressed as indicated below or as specified by subsequent written notice by the party whose address has changed. IF TO THE COMMUNITY: Ellison of Statesman Club 10401 Vineyard Blvd., Oklahoma City, OK 73120 IF TO RESIDENT: IF TO RESPONSIBLE PARTY: 5.21 Other Residents: Resident shall have no right to object or to determine the acceptance, placement or termination of any other resident or non-resident participating in the Community’s programs. The Community may enter into agreements with other residents that contain terms different from those contained in this Agreement. Despite such differences, this Agreement alone sets forth the rights and obligations of Resident with respect to the services provided by the Community. 5.22 Accuracy of Documents: You warrant that all information contained in any Exhibit, form or other document referenced in this Agreement or submitted by you as a condition to your acceptance for residency at the Community is true and correct, and you understand that we have relied on this information in accepting you for residency at this Community. Any misrepresentation or omission made by you or on your behalf, whether written or verbal, shall be grounds for our termination of this Agreement. 5.23 Bed Bugs: The Community represents and warrants that it is not aware of any current infestation or presence of bed bugs in the apartment you have chosen. Resident agrees to abide by the Bed Bug Policy attached as Exhibit I. 5.24 Annual Cleaning: The Community has the right to conduct a deep cleaning, including carpet cleaning, of Resident’s apartment on an annual basis. The Community shall contact Resident in advance of such cleaning to schedule a mutually convenient time and date for such cleaning. Resident would be required to pay for all the costs of such cleaning. 5.25 Respite Care: Subject to the availability of an appropriate apartment, a new Resident may utilize The Community for a respite stay. In such event, Resident and The Community shall have executed the Respite Addendum attached as Exhibit J hereto. In the event that Resident requires a respite stay for a higher level of care during the term of this Agreement, and The Community has an available apartment in the area of the Community that provides such care, Resident and The Community shall enter into the Respite Addendum attached as Exhibit K. 5.26 Responsible Party: If a Responsible Party was required by The Community to be a Party to this Agreement, the Responsible Party hereby guarantees payment of all amounts due from the Resident hereunder, promises to ensure performance of all obligations of the Resident, and agrees to take responsibility for the Resident upon termination of this Agreement. If The Community did not require a Responsible Party to enter into this Agreement, all references to Responsible Party in this Agreement shall be ignored and shall have no force or effect. 5.27 Legal Counsel: THE COMMUNITY RECOMMENDS THAT BOTH THE RESIDENT AND RESPONSIBLE PARTY CONSULT LEGAL COUNSEL TO ENSURE A FULL UNDERSTANDING OF THIS AGREEMENT BEFORE SIGNING. 5.28 Internet Access: Resident acknowledges that he or she has been offered the opportunity to procure wireless internet access and has either chosen to purchase monthly internet access or declined this servicing by completing the Wireless Internet Access Form attached as Exhibit M. 5.29 Release of Information: All information regarding Resident and this Agreement shall remain confidential and shall not be disclosed by the Community to Resident’s family, friends or other third parties without the written consent of Resident. 5.30 Wheelchair Waiver: In the event that Resident utilizes a wheelchair, Resident shall sign the Community’s Liability Waiver for Wheelchair attached as Exhibit N. 5.31 Anti-Bullying Policy: Resident will be required to sign the Community’s Anti-Bullying Policy attached as Exhibit O. 5.32 Motorized Ambulation Aids: Motorized ambulation aids (scooters/wheelchairs) are permitted and may be utilized by Residents provided the Resident reviews and signs the Motorized Ambulation Aids Policy attached as Exhibit R. SECTION 6: DISPUTE RESOLUTION Any controversy, dispute or claim arising out of or relating to this Agreement or breach thereof shall first be settled through good faith negotiation. If the dispute cannot be settled through negotiation, the Parties agree to attempt in good faith to settle the dispute by mediation administered through a mediator mutually agreed upon by the Parties. Mediation shall occur in a mutually agreeable location. The Parties shall share equally in the cost of mediation. If the Parties are unsuccessful at resolving the dispute through mediation, the Parties shall submit the dispute to arbitration before a single arbitrator appointed in accordance with the commercial arbitration rules of the American Arbitration Association ("AAA"). The commercial rules and procedures of the AAA shall govern the proceedings. The arbitrator will be fully compensated in accordance with their normal hourly or per diem rates for all time spent by them in connection with the arbitration proceeding. All costs of the arbitration will be shared equally among the Parties and will be paid not less than quarterly. The location of the arbitration shall be in Fort Worth, Texas. The Parties acknowledge that The Community is involved in transactions involving interstate commerce, the Agreement involves such conduct and that federal law, including the Federal Arbitration Act, Title 9 of the United States Code will govern the interpretation, enforcement and all judicial proceedings with respect to the arbitration and this provision. Should the Federal Arbitration Act be held unenforceable or, for any reason, not applicable, the state’s common law shall govern this arbitration and all judicial proceedings related thereto. Discovery and other procedural matters may generally follow the state’s Rules of Civil Procedure; provided, however, that the Parties will be free to agree upon, and the arbitrator will be free to prescribe such discovery and other procedures as shall facilitate the fair, impartial and expeditious completion of the arbitration and strict compliance with the state’s Rules of Civil Procedure will not be required. The arbitrator may grant pre-award and post-award interest at commercial rates existing during the relevant period of time. The arbitrator may also award all or part of a prevailing Party’s reasonable attorney’s fees, taking into account the final result of the arbitration, the conduct of the Parties and their counsel during the course of the arbitration and other factors that the arbitrator may deem to be relevant. The decision of the arbitrator shall be final and legally binding and judgment may be entered thereon. SECTION 7: INDEMNIFICATION & LIMITATION OF LIABILITY 7.1. Definitions: For the purposes of Section VII Indemnification and Limitation of Liability, the following terms have the following respective meanings: "Claim" means any liability, obligation, claim, cause of action (whether sounding in contract, tort, or otherwise), debt, damage (including, without limitation, special, incidental, indirect or consequential damage), loss, obligation, penalty, fine, dispute, settlement, compromise, cost and/or expense (including, without limitation, attorneys' fees, court costs and/or costs of investigation, whether or not in connection with litigation) of each and every kind whatsoever, in each case arising out of or in connection with (i) any injury to, or death of, any person (including you) for any reason or from any cause while at the Community, and/or (ii) any damage to the property of any person (including you and us) for any reason or from any cause while at the Community, except in each case with respect to clauses (i) and (ii) above, to the extent that such injury, death and/or damage results from the negligence of The Community. "Community Exercise Facilities" means, collectively and to the extent applicable, the Community’s exercise and physical-fitness equipment and facilities, swimming pool, and other similar facilities and amenities. 7.2 Acknowledgments: You acknowledge and agree as follows: a. The Community cannot ensure your safety or welfare. As between you and The Community, you shall have sole responsibility for your own actions and inactions, as well as for the actions and inactions of your family, guests, licensees, invitees and third-party caregivers. b. The Community shall not be liable for failure to perform any duties or obligations that may arise in connection with any event or condition beyond its control, including without limitation labor disputes, governmental regulations or controls, inability to obtain any materials or services at reasonable prices or otherwise, or acts of God (including, without limitation, fires, hurricanes, tornadoes and/or floods and other natural disasters). c. Wild animals could be present on the Community premises and should not be approached. You must notify a Community Associate immediately if you observe a dangerous animal on the Community premises. d. There is a possibility of injury, death and damage to property from using the Community Exercise Facilities and golf carts (if available). The Community is not obligated to monitor the Community Exercise Facilities or golf carts in any way and no such monitoring shall occur. Without limiting the generality of the foregoing, you acknowledge that the Community has a swimming pool and there is NO LIFEGUARD. You are responsible for being properly trained with respect to use of the Community Exercise Facilities and golf carts. e. You shall, and shall cause each of your family members and guests to do the following: (i) use Community Exercise Facilities and golf carts only with a complete understanding of how to use or operate them correctly, (ii) use all Community Exercise Facilities and golf carts safely and only in the manner intended by the manufacturer, (iii) not alter any Community Exercise Facilities or golf carts, (iv) use all Community Exercise Facilities (including without limitation) the swimming pool and golf carts at your own risk, (v) follow all of the Community’s rules relating to the Community Exercise Facilities and golf carts, and (vi) promptly report any need for maintenance or repair of any Community Exercise Facilities or golf cart to a Community Associate. No pets or children under 18 years old are allowed in the Community Exercise Facilities. No children under 18 years old are allowed to operate golf carts. The right to use the Community Exercise Facilities and golf carts is a nonexclusive privilege that we may revoke at any time. We may alter the hours of availability of the Community Exercise Facilities at any time. f. Use of the Community’s transportation services shall be deemed to constitute (i) your specific representation that you (A) are capable of using such transportation services without any assistance (other than a wheelchair lift, if applicable, for loading or unloading); (B) are aware of all necessary information regarding the destination(s) with respect to mobility, accessibility and physical safety, and (C) are capable of maneuvering unassisted at the destination(s), and (ii) your agreement to wear a seatbelt while a passenger in a Community vehicle and to abide by accepted safety procedures and the instructions of Community Associates. g. By signing this Agreement, Resident agrees that upon surrender, abandonment, or recovery of possession of the dwelling apartment due to the death of the last remaining Resident, the Community shall NOT be liable or responsible for storage or disposition of the Resident’s personal property. h. By signing this Agreement, Resident acknowledges that he or she has read the Community’s CPR Policy attached as Exhibit P. 7.3 Release: You, on your own behalf and on behalf of each person or entity claiming through you, hereby release, compromise and discharge The Community from and against all Claims (as such term is defined in Section 7.1 above) and agree to indemnify, defend, and hold harmless The Community from and against any and all Claims made by a third party. You knowingly and voluntarily assume all risks of living in the Community. In consideration of the terms contained in this Agreement, The Community hereby leases to the Resident the premises known as apartment number 216 as of this date of financial possession; 11/30/2022. IN WITNESS HEREOF, the Parties hereto have executed this Agreement on the date indicated beside each signature: Resident Signature Date Resident Responsible Party Signature (if different) Date Bishop Statesman Club Lessee LLC dba Ellison Independent Living of Statesman Club By: Name: Title: Date: EXHIBIT D: THIRD-PARTY PROVIDER POLICY The following guidelines are intended to assist our Residents in their employment of attendants, home health/hospice agencies or other third-party service providers. The purpose of these guidelines is to protect you and the Community. 1. If you utilize the service of a private duty attendant, he or she is your employee. You are responsible for all wages, employee benefits, payroll withholdings, Workers’ Compensation insurance, and other responsibilities of employers to employees. You should keep adequate records of the employment of your employee, including hours, wages, absences and other pertinent facts. 2. Confirm that your attendant is working only for you and not billing his or her time to another Resident during your scheduled appointment. 3. Your attendant must: • dress professionally and wear a name badge; • sign in and out at the front desk and communicate all changes or concerns to the Community nurse or Executive Director; • follow the Community smoking policy. If smoking is permitted, it must be in designated areas; • park only in designated parking areas; • never solicit business from other Residents; • have access to areas only necessary to perform care; • not loitering on Community property and provider is to leave premises when work is completed; • maintain the confidentiality of all Resident’s protected health information (in situations in which the service provider may obtain this information to perform services); • not recruit associates from the Community during the time they provide service and for one year after this contract is terminated; • report any falls, injury, or change of condition of the Resident to Community associates; • any sharps or biohazard waste must be disposed of in required sharps/biohazard container; • provide the Community copies of any relevant information to assist with the coordination of Resident care and services; • refrain from malicious gossip, spreading rumors, harassment, discriminatory remarks, or accusations; • honor Resident Rights (posted). 4. The Community reserves the right to exclude any attendant from the Community. You may not utilize the services of any attendant who has been excluded. WAIVER AND RELEASE The Resident specified below understands the potential problems and risks that can occur upon the hiring of private duty attendants or contracting with home health/hospice agencies or other third parties. The Resident agrees that the Community has no obligation to check or investigate the background of the Attendants retained. The Resident hereby waives, and releases the Community from any all claims, causes of action, demands, obligations, damages or liability asserted or arising out of or incidental to any dealings between the Resident and the Attendants retained. The Resident shall further indemnify the Community for any and all costs, claims, liabilities, damages and expenses incurred by the Community relating to the Resident’s engagement of such Attendants. Resident Name (Printed) Shr M Lynne-Budge Resident Signature Sheryl Omar Date 11/30/2022 Resident Responsible Party Signature Date 11/30/2022 EXHIBIT G: GUEST POLICY We encourage you to have family and friends visit you frequently. However, their visits are subject to certain policies intended to protect all Residents’ quiet enjoyment of the Community and to assure that one Resident’s guests do not unduly burden other Residents or interfere with the Community’s programs. These policies include the following: • All visitors must sign in and out at the front desk when entering or leaving the Community. • For the protection of all of the Community’s Residents and Associates, all guests must be free of contagious diseases. • Children must not play in the hallways, stairwells, elevators, or any other place that may be dangerous. Children must be accompanied by an adult who is capable of supervising them at all times. • Your guests are encouraged to accompany you to activities at the Community and to participate in those activities, provided the Executive Director receives reasonable notice of their participation and you (or your guests) pay any applicable fee for the activity. However, your guests may not participate in activities at the Community unaccompanied by you without the Executive Director’s advance written consent. • For their protection, your guests must not enter any rooms or other areas (such as boiler rooms and kitchens) where Residents are not allowed access. Likewise, your guests shall not enter other Residents’ apartments without their permission. • Before any visitor stays in your apartment overnight, you must notify the Executive Director in writing. Your guests may stay with you in your apartment for a maximum of seven (7) consecutive days and fourteen (14) days per calendar year. (There is no carry-forward of unused days in any calendar year.) Any stay beyond this period will be allowed only with the Executive Director’s prior written approval. There will be a guest accommodation fee for any such extended stay. • Your guests may not live in your apartment while you are absent from the Community. • The Community may maintain an apartment for overnight guests. Your guests are welcome to use the apartment, space permitting, for a maximum of seven (7) consecutive nights and fourteen (14) days per year. Because of limited availability, we require that you reserve the apartment as soon as you become aware of your guests’ plans. There is a nightly charge for use of the apartment. Meals are additional. • Laundry facilities (if any) at the Community are for the use of Residents only. If your guests require laundry services, please contact the concierge. Laundry services will be provided to your guests for a fee. • Your guests are welcome to accompany you to meals at the Community; however, we request that you give the Concierge reasonable advance notice of guest meals. (Greater notice may be required for holiday meals and special events.) You will be required to pay for all guest meals at the rates set forth in the Community’s current fee schedule. • The Community reserves the right to charge you extra fees if additional or more thorough housekeeping or maintenance is required as a result of your guests’ visits. • All guests must conduct themselves in a manner that does not jeopardize the health or safety of others at the Community or interfere with their quiet enjoyment of the premises. If the Community determines, in its sole discretion, that any guest does not meet these requirements, that person will be required to leave the premises immediately. • In order to respect the privacy and dignity of our Residents, guests may not photograph or videotape other Residents without consent from those Residents or their responsible parties. If a guest wishes to publish photos or video on websites or other social media sites they assume full responsibility for obtaining permission from all included Residents and Associates. • Residents are responsible for the conduct of their guests. The Community will have zero tolerance for any guest who is abusive to or threatens any Resident or Associate, who fails to follow the Community rules or who otherwise creates an unsafe condition. Any such guest will be asked to leave the premises immediately. Depending on the circumstances, the Community may also contact the local law enforcement agency. • The Community may develop additional policies, as it deems appropriate, to help assure that guests do not become a disturbance or burden to others at the Community. Resident Signature Date Resident Responsible Party Signature Date Community Representative Signature Date EXHIBIT H: EVACUATION POLICY In the event of a fire, hurricane, flood, terrorist attack, act of war, gas leak, chemical spill, or other natural or man-made disaster that requires the Community to evacuate residents from the building(s) (each, an "Evacuation Event"), Resident understands that he or she must physically evacuate the premises through his or her own efforts and cannot rely on the assistance of any Community Associate in connection with the evacuation process. Community is under no duty or obligation to physically assist any Resident in connection with the evacuation process. During an Evacuation Event, Resident is expected to follow the instructions of Associates in exiting the building as quickly as possible. Upon the sounding of an emergency alarm, Residents will move to the nearest assigned exit. Resident understands that elevators will likely not be in operation during an Evacuation Event. Consequently, residents whose apartments are located on floors above ground level understand that they will have to utilize the stairs in connection with the evacuation process. If Resident is unable to evacuate during an Evacuation Event without assistance, Resident will contact 911 and must rely on emergency personnel for assistance. Resident recognizes potential hazards and assumes risk associated with evacuating during an Evacuation Event and agrees to hold Community and its Associates harmless for any injuries incurred by the Resident in the evacuation process. I have read and understand the above Evacuation Policy and agree to comply fully with its provisions. I understand that in the event of an Evacuation Event, I am responsible for exiting the building through my own efforts without the assistance of Community Associates or other third parties. Resident Signature Resident Responsible Party Signature Date 12/1/22 Date 11/30/22 EXHIBIT I: BED BUG POLICY RESIDENT HEREBY REPRESENTS AND AVOWS TO THE COMMUNITY THAT RESIDENT DOES NOT CURRENTLY HAVE, AND HAS NOT HAD WITHIN THE PREVIOUS SIX (6) MONTHS, A BED BUG INFESTATION. Resident agrees not to, and Resident agrees to not allow any guests to, move any items into its apartment that the Resident knows, believes or should know that contains bed bugs. The Resident agrees to take reasonable steps to prevent, control and provide notice of any signs of bed bugs. Resident agrees to routinely inspect for signs of pests, including after Resident has visited another home or a hotel. Resident must report any signs of bed bugs immediately and in writing. Resident and guests of Resident agree to cooperate with The Community in all efforts and course of actions required to erase and control any pest/bedbug infestation. Resident’s full cooperation shall include but is not limited to: immediately reporting any pest infestation including that of bed bugs to The Community, and permitting any entry to complete any inspections, pre-treatment and treatment to eliminate any pests and or bed bugs. Resident understands that evacuating the premises during and after treatment for a specified time frame may be necessary. Resident will follow all directions and perform any critical actions to comply with all the post treatment requirements to keep the apartment pest free and minimize any re-infestations. If during the term of your residency bed bugs appear in the premises and a pest control professional determines that the bed bugs originated in the Resident’s apartment, Resident acknowledges and agrees that all necessary treatments for your apartment and other apartments that may be affected as a result, as well as any additional costs, expenses and losses will be at the Resident’s expense. Under no circumstances shall The Community and/or agents of The Community be held responsible for any of Resident’s losses, damages or expenses including special, consequential or punitive arising out of a bed bug infestation, inspection or treatment. Additionally, Resident agrees to indemnify and hold harmless The Community, its agents and Associates from any actions, claims, losses, damages, and expenses, including, but not limited to attorney’s fees that The Community may incur as a result of a bed bug infestation, inspection or treatment. This indemnification shall not apply if such damages, costs, losses, or expenses are directly caused by the gross negligence of The Community. Failure to promptly report bed bugs, failure to comply with treatment instructions, or any other violations of any other provisions of this policy shall be a material breach of this Agreement. I have read and understand the above Bed Bug Policy and agree to comply fully with its provisions. I understand that any breach of this policy is a breach of the Resident Agreement and shall constitute grounds for eviction. Resident Signature Date 12/14/22 Resident Responsible Party Signature Date 11/30/22 EXHIBIT L: WIRELESS INTERNET ACCESS The Community offers Wireless Internet Access at a cost of twenty-five dollars ($25.00) per month with up to three (3) devices per Resident. Resident Information: Resident(s) Name(s): Sheryl Candice Apartment/Cottage #: #116 [ ] Yes, I would like to purchase Wireless Internet Access for $25/month. [ ] No, I am not interested in Wireless Internet Access at this time. [Signature] Resident Signature 12/1/22 Date Resident Responsible Party Signature Date To be completed by Community Associate: Resident User ID Password EXHIBIT M: ELECTRONIC STATEMENTS Monthly billing statements may be delivered via e-mail. Please provide the e-mail address where you would like your statements received below: Resident Name: Shryl Cuthpe Apartment #: #216 Responsible Party (if applicable): loreangelc9 E-mail Address: @ gmail .com ☐ I cannot receive electronic statements and opt for paper statements only. Mailing Address: 900 N ASK GOS City: OKC State: OK Zip Code: 73414 Date: 12-1-22 Signature: [Signature present but illegible] Resident Responsible Party Signature Date: 1/30/22 EXHIBIT N: LIABILITY WAIVER FOR WHEELCHAIR Resident, by electing to use a wheelchair that Resident has independently acquired from a third-party, shall be deemed to represent that Resident (A) is capable of using such wheelchair without any assistance (other than a wheelchair lift, if applicable, for loading or unloading in connection with transportation services), and (B) understands and acknowledges that neither the Community, nor any Associate, has inspected the wheelchair or has advised Resident with respect to the proper usage of such wheelchair. Resident recognizes potential hazards and assumes risk associated with using a wheelchair and agrees to hold Community and its associates harmless for any injuries incurred. I have read and understand the above Liability Waiver for Wheelchair and agree to comply fully with its provisions. Resident Signature ____________________________ Date 12-1-22 Responsible Party Signature ____________________________ Date 11/30/20 Community Representative ____________________________ Date EXHIBIT O: ANTI-BULLYING POLICY The Community considers bullying unacceptable and will not tolerate it under any circumstances. This policy shall apply to all Residents of the Community, regardless of his/her Residential status (i.e. independent living, cottages, assisted living, or memory care). Any Resident found in violation of this policy may have their Resident agreement terminated and be forced to vacate the Community; subject to applicable law and regulation. The Community defines bullying as persistent, malicious, unwelcome, severe and pervasive mistreatment that harms, intimidates, offends, degrades or humiliates a Resident, whether verbal, physical or otherwise. The Community promotes a healthy Residential culture where all Residents are able to live, eat, and socialize in an environment free of bullying behavior. All Residents are encouraged to report any instance of bullying behavior. Any reports of this type will be treated seriously, and investigated promptly and impartially. The Community considers the following types of behavior to constitute bullying. Please note, this list is not meant to be exhaustive and is only offered by way of example: a. staring, glaring or other nonverbal demonstrations of hostility; b. exclusion or social isolation; c. personal attacks (angry outbursts, excessive profanity, or name-calling); d. encouragement of others to turn against the targeted Resident; e. stalking; f. unwelcome touching; g. invasion of another person’s personal space, h. repeated infliction of verbal abuse, such as the use of derogatory remarks, insults and epithets (including those relating to the use of wheelchairs, walkers and similar aids and devices by the targeted Resident); and i. conduct that a reasonable person would find hostile and offensive. Early reporting and intervention have proven to be the most effective method of resolving actual or perceived incidents of bullying. Therefore, while no fixed reporting period has been established, The Community strongly urges the prompt reporting of complaints or concerns so that rapid and constructive action can be taken. Every effort will be made to stop alleged bullying before it becomes severe or pervasive, but can only be done so with the cooperation of the Residents. Individuals who believe they have experienced conduct that they believe violates this policy, or who have concerns about such matters, should report their complaints verbally or in writing to the Executive Director before the conduct becomes severe or pervasive. The availability of this complaint procedure does not preclude individuals who believe they are being subjected to bullying conduct from promptly advising the offender that his or her behavior is unwelcome and requesting that such behavior immediately stop. I have read and understand the above Anti-Bullying Policy and agree to comply fully with its provisions. Resident Signature _____________________________ Date 12-1-22 Responsible Party Signature ___________________ Date 11/30/22 Community Representative ______________________ Date ___ EXHIBIT P: CPR POLICY In the event that a loss of vital signs of a Resident is noticed, it is the policy of the Community to call 911 and follow the instructions provided by the operator/dispatcher until medical personnel arrive in response to such call. Resident Signature ____________________________ Date 12-1-22 Responsible Party Signature ____________________________ Date 11/30/22 Community Representative ____________________________ Date EXHIBIT Q: PET POLICY The Community recognizes that under certain circumstances a Resident’s pet may be considered a service or emotional support animal, or other similar qualified animal ("Service Animal") under applicable state and federal laws, including but not limited to the Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act and other applicable state and federal statutes and/or regulations ("Applicable Law"). Should an animal or pet qualify as a Service Animal under Applicable Law, The Community will make such accommodations and access for such Service Animal as may be required for compliance with Applicable Law. To the extent any provisions of this policy conflict with Applicable Law, it shall not be considered to apply to a Resident’s Service Animal and Applicable Law will control. All provisions of this Policy not inconsistent with, or contrary to, Applicable Law shall apply to all pets, including Service Animals. Subject to the foregoing, the following policy governs the presence of pets in The Community: 1. This policy is designed for Residents to have the opportunity to bring their family pet that they have grown attached to over the years. 2. All pets are subject to an initial review by The Community management to determine whether or not the pet is acceptable for living at The Community. 3. Only small dogs, house cats, birds, and fish will be considered for occupancy. A copy of current veterinarian records will be required before move-in to show that the cat, dog, or bird is in good health and that shots are current. The Resident will be required to keep all required vaccinations for the animal current and to provide a copy of such to the office. 4. All pets will require a non-refundable pet deposit and a monthly pet rent. Resident’s liability for damages caused by his or her pet is not limited to the amount of the pet deposit, and the Resident will be required to reimburse the Community for the actual costs of any and all damages caused by his or her pet, including landscape replacement, professional cleaning and/or deodorizing and pest elimination. 5. Management may limit dogs to the first floor, preferably near exit doors. 6. Cats may be de-clawed, a “house” cat, neutered or spayed, and trained to use a litter box. A Resident may be limited to one dog or cat per apartment. 7. Cat owners must provide a litter box maintained with odor reducing kitty litter and empty the litter box at least twice per week or more often if deemed necessary by The Community. 8. Dog owners are responsible for walking their own dog in the designated pet areas and picking up after the dog. 9. Pet owners are responsible for supplying and cleaning any pet cage, crate, etc. 10. No animals are allowed in the Common Areas of the Community, including hallways. This rule applies also to visiting pets. Pets must enter and exit the building through side entrances and exits, not the main entrance. All cats and dogs and other pets must be appropriately and effectively restrained and under the control of a responsible individual while on The Community’s premises. 11. Residents must cage or crate their animals when The Community Associates enter the residence to provide service. The Resident will be responsible for any injury to The Community Associates or other residents caused by the pet. 12. If, in the opinion of The Community management, the Resident fails to properly care for his or her pet, The Community’s Executive Director has sole authority to determine whether the pet may remain at The Community. The Executive Director may, in his or her sole discretion, give the Resident up to ten (10) days to make other arrangements for the pet. If the health or safety of a pet is threatened by the death or incapacity of the Resident, or by other factors that render the Resident unable to care for the pet, The Community may contact the Responsible Party or heirs of the Resident. If such parties are unable or unwilling to care for the pet, or The Community, despite reasonable efforts, has been unable to contact responsible parties, The Community may contact appropriate state or local authorities or organizations authorized to remove a pet under such circumstances. 13. If The Community determines a pet to be a nuisance to other Residents, The Community’s Executive Director will give the Resident up to five (5) days to correct the situation. If the situation is not corrected within this time-frame, the pet must leave The Community. The Executive Director may, in his/her sole discretion, implement this change by giving the Resident up to ten (10) days to make other arrangements for the pet. 14. In the event that The Community must be evacuated, the Resident or Responsible Party must ensure that arrangements are made for care and transportation of the pet. No care will be provided in an evacuated Community. Any expenses incurred in relation to care or transportation of the pet are the sole responsibility of the Resident. 15. The Community management reserves the right to limit the total number of pets in the Community. I have read and understand the above Pet Policy and agree to comply fully with its provisions. I understand that any breach of this policy is a breach of the Resident Agreement and may constitute reason for removal of my pet. If required by The Community to remove my pet from the premises, I agree to effect such removal and understand that my failure to do so shall constitute grounds for eviction. Resident Signature Date 12-1-22 Responsible Party Signature Date 11/30/22 Community Representative Date EXHIBIT R: MOTORIZED AMBULATION AIDS POLICY The Community's policy is to ensure Residents and visitors who use motorized ambulation aids due to a disability or otherwise have full access to Community facilities and Residential apartments, and to promote a safe environment for all Residents and visitors, including establishing appropriate guidelines for use of motorized ambulation aids. A Resident who requires a motorized ambulation aid is not required to prove that he or she needs such an aid. However, it is expected that Residents using a motorized ambulation aid shall be fully familiar with its operation, and be able to safely operate it without impacting the health or safety of others, or causing physical damage to the property of others, including The Community. Residents and visitors must comply with The Community's safety rules. The Community's Executive Director may prohibit a Resident or visitor from using his or her motorized ambulation aid if the Resident refuses to abide by this policy. 1. Motorized ambulation aids are permitted in any area of the Community unless they pose a direct threat to either the safety of the individual or others or would result in physical damage to the property of others, including The Community. 2. Residents who use motorized ambulation aids shall have access to and within the dining rooms. The Community may designate or set aside certain seating pursuant to the request of Residents who use motorized ambulation aids or to ensure that motorized ambulation aids do not block ingress or egress of others in the case of an emergency. Upon request, The Community may also provide reasonable accommodations specific to the needs of persons using motorized ambulation aids. The Resident may be requested to transfer from the motorized aid to a manual ambulation aid if possible before entering the dining rooms if required for safety and space reasons. 3. The Resident must be able to demonstrate to The Community associates that the Resident is capable of operating the device in a way that poses no threat of injury to Resident, fellow Residents, associates or property. Residents and visitors shall operate the motorized ambulation aids in a conservative and safe manner, taking special precautions near doorways, at corners, when approaching pedestrians, when backing up, and in other situations that present an additional risk of injury or alarm to others in the vicinity, and shall not operate their motorized ambulation aid in any way that creates a disturbance or threat of harm to the driver or others, or damage to community property. 4. The Resident agrees to operate the device at a speed that is comparable to, and not faster than, the speed at which the average Resident walks. Pedestrians shall always have the right of way over motorized ambulation aids, whether indoors or outdoors. 5. The Resident, by signing this policy, understands and agrees that he or she is responsible for all property damage or injuries caused by the improper use of a motorized device. While not required, it is recommended that the Resident obtain insurance for personal injury/property damage in an amount of at least one hundred thousand dollars ($100,000) to protect against financial loss for any such liability. This insurance may be obtained as part of a renter's insurance policy. 6. A Resident may be restricted in the use of his or her motorized ambulation aid if such use constitutes a direct threat to the health or safety of the Resident or others, or would result in physical damage to the property of others. In such cases, The Community will restrict the use of motorized ambulation aids until such time as the Resident is no longer a direct threat to the health or safety of themselves or others, or would not cause physical damage to the property of others, including The Community. I have read and understand the above Motorized Ambulation Aids Policy and agree to comply fully with its provisions. Resident Signature Date 12-1-22 Responsible Party Signature Date 11/30/20 Community Representative Date EXHIBIT S: TRANSPORTATION WAIVER Resident by electing to use the transportation services offered by The Community, shall be deemed to represent that Resident (A) is capable of using such transportation services without any assistance (other than a wheelchair lift, if applicable, for loading or unloading); (B) is aware of all necessary information regarding the destination(s) with respect to mobility, accessibility and physical safety, and (C) is capable of ambulating or maneuvering (with or without assistive devices) at the destination(s). While a passenger in an The Community vehicle, each Resident must wear a seatbelt and abide by accepted safety procedures and the instructions of The Community's Associates. Resident recognizes potential hazards and assumes risk associated with using this provided transportation and agrees to hold The Community and its Associates harmless for any injuries incurred, aside from injuries sustained by the Resident in a moving motor vehicle accident while Resident is a passenger in an The Community vehicle. I have read and understand the above Transportation Waiver and agree to comply fully with its provisions. Resident Signature ___________________________ Date 12-1-22 Responsible Party Signature __________________ Community Representative __________________ Date ________________ LR: 5/30/2019 Oklahoma IL/CG Page 22 of 20 Sheryl Cudjoe Ellison of Statesman Club Statement Date: 1/1/2023 Printed Date: 12/22/2022 Resident Name: Sheryl Cudjoe Payor ID: 90312668 Property Address: 10401 Vineyard Blvd Oklahoma City, OK 73120 Summary <table> <tr> <th>Prior Balance</th> <th>Payments</th> <th>Total Due</th> </tr> <tr> <td>($2,257.00)</td> <td>$0.00</td> <td>$3,631.19</td> </tr> </table> Charges <table> <tr> <th>Charge</th> <th>From</th> <th>To</th> <th>Quantity</th> <th>Rate</th> <th>Frequency</th> <th>Amount</th> </tr> <tr> <td>IL Community Fee</td> <td>11/30/22</td> <td>11/30/22</td> <td>1.00</td> <td>$1,300.00</td> <td>One time</td> <td>$1,300.00</td> </tr> <tr> <td>One-time move-in</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>Independent Living</td> <td>12/01/22</td> <td>12/31/22</td> <td>1.00</td> <td>$2,257.00</td> <td>Monthly</td> <td>$2,257.00</td> </tr> <tr> <td>Independent Living</td> <td>11/30/22</td> <td>11/30/22</td> <td>1.00</td> <td>$2,257.00</td> <td>Monthly Prorated</td> <td>$74.19</td> </tr> <tr> <td>Independent Living</td> <td>01/01/23</td> <td>01/31/23</td> <td>1.00</td> <td>$2,257.00</td> <td>Monthly</td> <td>$2,257.00</td> </tr> <tr> <td colspan="6">Total Statement Period Charges</td> <td>$5,888.19</td> </tr> </table> Aging Summary <table> <tr> <th>0 to 30 Days</th> <th>31 to 60 Days</th> <th>61 to 90 Days</th> <th>90 Days</th> </tr> <tr> <td>$1374.19</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> </table> M/1 pd (12/19) apartment ready but wasn't ready 405-402-4617 Gladys November 11/30 rent 79.19 cf $300 December rent at credit was short January 2257 rent Remittance Elison of Statesman Club 10401 Vineyard Blvd Oklahoma City, OK 73120 Sheryl Cudjoe Ellison of Statesman Club 10401 Vineyard Blvd Unit: 216 Total Due: $3,631.19 Resident Name: Sheryl Cudjoe Resident ID: 00022946 Residency Agreement Amendment Addendum S This amendment is made to the Residency Agreement previously executed by and between Sheryl Cudjoae ("Resident") and Elison Independent Living of Statesman Club (the "Community") is made as of this day 8/1/2025. Except as set forth in this amendment, the Residency Agreement is unaffected and shall continue in full force and effect in accordance with its terms. It is mutually understood and agreed by and between the undersigned contracting parties to amend the previously executed agreement as follows: Current Apartment or Cottage #216 Current Base Rental Rate $2695 New Base Rental Rate $2911 Rate Lock through December 31, 2027 I have read and understand the above Residency Agreement Amendment and agree to comply fully with its provisions [Signature] 7/27/25 Resident Signature [Signature] 7/27/25 Responsible Party Signature [Signature] 7/26/25 Executive Director/Signature July 31, 2025 Via Hand Delivery And Certified Mail, Return Receipt Requested ____________ Shryl Cudjoe 10401 Vineyard Blvd Apt #216 Oklahoma City, OK 73120 Re: Termination of Residency Dear Ms. Cudjoe, Reference is made to that certain Residency Agreement (the "Agreement") dated as of November 30, 2022, by and between Shryl Cudjoe ("Resident") and Bishop Statesman Club Lessee LLC dba Elison Independent Living of Statesman Club ("Elison Statesman Club" or "Community"). This letter is written notice that Elison Statesman Club is terminating your residency. You are hereby given notice that pursuant to Section 3.2d. of the Agreement, Elison Statesman Club is terminating your residency for the reason of nonpayment of the Monthly Fees for more than 30 days past the due date. Your total past due balance is $2,802.68. Upon receipt of this termination letter, you must vacate the apartment within 30 days. The date of this notice is July 31, 2025. The date this notice was given to you is July 31, 2025, by hand delivery and certified mail. The date by which you must leave Elison Statesman Club is on or before August 30, 2025.. We appreciate your interest in Elison Statesman Club, and we wish you the best of luck with your future arrangements. Sincerely, Bishop Statesman Club Lessee LLC dba Elison Independent Living of Statesman Club By: Phillip Beeson Title: Executive Director U.S. Postal Service® CERTIFIED MAIL RECEIPT Domestic Mail Only __________________________________________________________ TRACK STATUS BY TEXT MESSAGE Send tracking number to 26777 (2USPS) Standard message and data rates may apply __________________________________________________________ TRACK STATUS ONLINE Visit https://www.usps.com/tracking Text and e-mail alerts available __________________________________________________________ PURCHASE DETAILS Product Qty Unit Price Price First-Class Mail Letter 1 $0.78 Oklahoma City, OK 73120 Weight: 0 lb 0.50 oz Estimated Delivery Date Mon May 23 Certified Mail $5.30 Tracking #: 9598 0710 5270 0331 5511 24 Return Receipt $4.40 Track #: 9598 9402 6283 3094 0298 39 Total $10.48 Grand Total: $10.48 Cash $10.48 __________________________________________________________ TO REPORT AN ISSUE Visit https://emailhub.usps.com In a hurry? 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UFN: 396140-0031 Receipt #: 540-57300684-2-10354818-1 Clerk: 34 Resident Detail Ledger Elison of Statesman Club (okcy) Cudjoe, ShmY (00022946) Statement <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check Number</th> <th>Effective</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>01/2023</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>12/01/2022</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>12/01/2022 - 12/31/2022</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$2,257.00</td> <td>$2,257.00</td> <td>$2,257.00</td> </tr> <tr> <td>12/01/2022</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>11/30/2022</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$2,331.19</td> <td>$74.19</td> <td>$2,331.19</td> </tr> <tr> <td>12/01/2022</td> <td>IL Community Fee</td> <td>Cudjoe, ShmY (90312668)</td> <td>11/30/2022 - 11/30/2022</td> <td>1</td> <td>$1,300.00</td> <td>$0.00</td> <td>$1,300.00</td> <td>$3,631.19</td> <td>$1,374.19</td> <td>$3,631.19</td> </tr> <tr> <td>12/01/2022</td> <td>Discount on IL Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>12/01/2022 - 12/01/2022</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$1,374.19</td> <td>$2,257.00</td> <td>$3,631.19</td> </tr> <tr> <td>12/20/2022</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>01/01/2023 - 01/31/2023</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td></td> <td></td> <td></td> </tr> <tr> <th colspan="11">02/2023 Statement Totals:</th> <th></th> </tr> <tr> <td>01/06/2023</td> <td>One Time EFT Receipt: EFT Payment Paid by Payer ShmY Cudjoe (90312668), Reversed By ct# 741161 Voucher No.: :ACH Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-312940</td> <td>01/06/2023</td> <td></td> <td></td> <td></td> <td></td> <td>$2,257.00</td> <td>$0.00</td> <td>$5,888.19</td> </tr> <tr> <td>01/12/2023</td> <td>One Time EFT Receipt: EFT Payment Paid by Payer ShmY Cudjoe (90312668), Reversed By ct# 741705 Voucher No.: :ACH Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-313659</td> <td>01/12/2023</td> <td></td> <td></td> <td></td> <td></td> <td>$1,374.19</td> <td>$0.00</td> <td>$5,888.19</td> </tr> <tr> <td>01/12/2023</td> <td>Reverse receipt Ct#: 739653 Cudjoe, ShmY (90312668)</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-312940</td> <td>01/12/2023</td> <td></td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$2,257.00</td> <td>$3,631.19</td> </tr> <tr> <td>01/18/2023</td> <td>Reverse receipt Ct#: 741098 Cudjoe, ShmY (90312668)</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-313559</td> <td>01/18/2023</td> <td></td> <td>$1,374.19</td> <td>$0.00</td> <td>$2,257.00</td> <td>$5,888.19</td> <td>$5,888.19</td> </tr> <tr> <td>01/24/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>02/01/2023 - 02/28/2023</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td></td> <td></td> <td>$5,888.19</td> </tr> <tr> <th colspan="11">02/2023 Statement Totals:</th> <th></th> </tr> <tr> <td>02/03/2023</td> <td>Pre-Authorized Payment Reversed by ct# 753952 Voucher No.: :ACH Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-317624</td> <td>02/03/2023</td> <td></td> <td>$5,888.19</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,888.19</td> </tr> <tr> <td>02/08/2023</td> <td>Reverse receipt Ct#: 751025 Cudjoe, ShmY (90312668)</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-317624</td> <td>02/08/2023</td> <td></td> <td>$5,888.19</td> <td>$0.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$8,145.19</td> </tr> <tr> <td>02/21/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>03/01/2023 - 03/31/2023</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td></td> <td></td> <td>$8,145.19</td> </tr> <tr> <th colspan="11">03/2023 Statement Totals:</th> <th></th> </tr> <tr> <td>03/03/2023</td> <td>:CHECKscan Payment Voucher No.: :ACH/X9 Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>9184531318</td> <td>03/03/2023</td> <td></td> <td>$3,000.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,145.19</td> <td>$5,145.19</td> </tr> <tr> <td>03/10/2023</td> <td>:CHECKscan Payment Reversed by ct# 768229 Voucher No.: :ACH/X9 Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>5692</td> <td>03/10/2023</td> <td></td> <td>$1,500.00</td> <td>$0.00</td> <td>$0.00</td> <td>$3,645.19</td> <td>$3,645.19</td> </tr> <tr> <td>03/15/2023</td> <td>Reverse receipt Ct#: 767946 Cudjoe, ShmY (90312668)</td> <td>Cudjoe, ShmY (90312668)</td> <td>5692</td> <td>03/15/2023</td> <td></td> <td>$1,500.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,145.19</td> <td>$5,145.19</td> </tr> <tr> <td>03/21/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, ShmY (90312668)</td> <td>04/01/2023 - 04/30/2023</td> <td>1</td> <td>$2,460.00</td> <td>$0.00</td> <td>$2,460.00</td> <td>$7,605.19</td> <td>$7,605.19</td> <td>$7,605.19</td> </tr> <tr> <th colspan="11">04/2023 Statement Totals:</th> <th></th> </tr> <tr> <td>05/2023</td> <td>One Time EFT Receipt: EFT Payment Paid by Payer ShmY Cudjoe (90312668), Reversed By ct# 73868 Voucher No.: :ACH Deposit</td> <td>Cudjoe, ShmY (90312668)</td> <td>:ACH-326108</td> <td>03/27/2023</td> <td></td> <td>$1,500.00</td> <td>$0.00</td> <td>$0.00</td> <td>$6,105.19</td> <td>$6,105.19</td> </tr> </table> <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check Number</th> <th>Effective Date</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>04/03/2023</td> <td>:CHECKscan Payment</td> <td>Cudjoe, Shrvl (90312668)</td> <td>9184551548</td> <td>04/03/2023</td> <td></td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$3,405.19</td> <td></td> </tr> <tr> <td>04/07/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>04/07/2023</td> <td></td> <td>1</td> <td>$2,460.00</td> <td>$0.00</td> <td>$12,460.00</td> <td>$945.19</td> </tr> <tr> <td>04/07/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>04/07/2023 - 04/30/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$17,217.00</td> <td>$871.00</td> </tr> <tr> <td>04/07/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>04/01/2023 - 04/30/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$19,474.19</td> <td>$3,128.00</td> </tr> <tr> <td>04/10/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>04/10/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$3,202.19</td> </tr> <tr> <td>04/24/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>04/24/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$5,459.19</td> </tr> <tr> <td colspan="9"><b>Statement Totals:</b></td> <td>(-$4,200.00)</td> <td>($4,588.19)</td> <td><b>$5,459.19</b></td> </tr> <tr> <td>05/2023</td> <td colspan="3">05/02/2023 :CHECKscan Payment<br>Voucher No.:ACH/X9 Deposit<br>05/16/2023 Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td>160800180</td> <td>05/02/2023</td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>($3,203.00)</td> <td><b>$2,534.19</b></td> <td><b>$4,588.19</b></td> </tr> <tr> <td>06/2023</td> <td colspan="3">06/01/2023 One Time EFT Receipt: EFT Payment: EFT Payment: Paid<br>Voucher No.:ACH/X9 Deposit<br>06/06/2023 Reverse receipt Crn# 8044102<br>Voucher No.:CHECKscan<br>06/12/2023 Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td>9184532131</td> <td>06/01/2023 - 06/30/2023</td> <td></td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>($4,513.19)</td> <td><b>$5,459.19</b></td> </tr> <tr> <td>06/01/2023</td> <td>One Time EFT Receipt: EFT Payment: EFT Payment: Paid<br>Voucher Nr.:ACH/X9 Deposit</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>06/01/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td><b>($4,513.19)</b></td> <td><b>$5,459.19</b></td> </tr> <tr> <td>06/01/2023</td> <td>:CHECKscan Payment<br>by Payer Shrvl Cudjoe<br>Drtn# 807848 Voucher No.:ACH/X9 Deposit</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>06/01/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td><b>($4,513.19)</b></td> <td><b>$5,459.19</b></td> </tr> <tr> <td>06/06/2023</td> <td>:CHECKscan Payment<br>Voucher No.:CHECKscan<br>Deposit</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>06/06/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>($4,513.19)</td> <td><b>$5,459.19</b></td> </tr> <tr> <td>06/12/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>06/12/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>($4,470.19)</td> <td><b>$4,470.19</b></td> </tr> <tr> <td>07/2023</td> <td colspan="3">07/20/2023 Statement Totals:</td> <td></td> <td></td> <td></td> <td>$12,300.00</td> <td>$0.00</td> <td>$2,257.00</td> <td><b>$4,377.19</b></td> <td><b>$4,377.19</b></td> </tr> <tr> <td>06/20/2023</td> <td>:CHECKscan Payment<br>Voucher No.:CHECKscan<br>Deposit</td> <td>Cudjoe, Shrvl (90312668)</td> <td>160811372</td> <td>06/20/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td><b>$0.00</b></td> <td><b>$4,377.19</b></td> </tr> <tr> <td>07/12/2023</td> <td>Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)</td> <td></td> <td>08/01/2023 - 08/31/2023</td> <td></td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td><b>$0.00</b></td> <td><b>$4,377.19</b></td> </tr> <tr> <td>08/2023</td> <td colspan="3">08/15/2023 Late Fees<br>08/15/2023 Check Processing Fee<br>08/21/2023 Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)<br>Cudjoe, Shrvl (90312668)<br>Cudjoe, Shrvl (90312668)</td> <td>9234830442<br>9184532684<br>08/09/2023</td> <td>08/15/2023 - 08/15/2023<br>08/09/2023 - 08/09/2023<br>09/01/2023 - 09/30/2023</td> <td>1<br>1<br>1</td> <td>$103.86<br>$0.00<br>$2,257.00</td> <td>$103.86<br>$0.00<br>$2,257.00</td> <td><b>($133.95)</b><br>$0.00<br>$2,148.05</td> <td><b>($133.95)</b><br>$0.00<br>$2,148.05</td> </tr> <tr> <td>09/2023</td> <td colspan="3">09/11/2023 :CHECKscan Payment<br>Voucher No.:ACH/X9 Deposit<br>09/11/2023 Check Processing Fee<br>09/20/2023 Independent Living Rent</td> <td>Cudjoe, Shrvl (90312668)<br>Cudjoe, Shrvl (90312668)<br>Cudjoe, Shrvl (90312668)</td> <td>9234830840<br>09/11/2023<br>10/01/2023 - 10/31/2023</td> <td>09/11/2023<br>09/11/2023<br>10/01/2023 - 10/31/2023</td> <td>$2,190.00<br>$0.00<br>$2,257.00</td> <td>$2,190.00<br>$0.00<br>$2,257.00</td> <td><b>$2,148.05</b><br>$0.00<br>$2,148.05</td> <td><b>($16.95)</b><br>$0.00<br>$2,148.05</td> </tr> <tr> <td>10/2023</td> <td colspan="3">Statement Totals:</td> <td></td> <td></td> <td></td> <td>$12,190.00</td> <td>$0.00</td> <td>$2,385.86</td> <td><b>$2,148.05</b></td> <td><b>$2,240.05</b></td> </tr> </table> Resident Detail Ledger Tuesday, January 27, 2026 Elison of Statesman Club (0kcv) Cudjoe, ShyrL (00022946) Statement Date Description Payer Check Number Effective Quantity Rate Payments Credits Charges Balance 11/2023 10/05/2023 ;CHECKscan Payment Cudjoe, ShyrL (90312668) 9184533193 10/05/2023 $0.00 $0.00 $0.00 $0.05 Voucher No.: ACH/Y9 Deposit Cudjoe, ShyrL (90312668) 10/06/2023 Check Processing Fee Cudjoe, ShyrL (90312668) 10/01/2023 - 10/31/2023 1 $25.00 $0.00 $25.00 $25.05 10/11/2023 ;CHECKscan Payment Cudjoe, ShyrL (90312668) 4019555451704 09/06/2023 $5.00 $0.00 $0.00 $20.05 10/20/2023 Voucher No.: ACH/Y9 Deposit Cudjoe, ShyrL (90312668) 09/06/2023 $59.95 $45.05 Check Processing Fee Cudjoe, ShyrL (90312668) 11/01/2023 - 11/30/2023 1 $25.00 $0.00 $25.00 $45.05 Independent Living Rent Cudjoe, ShyrL (90312668) 11/01/2023 - 11/30/2023 1 $2,257.00 $2,257.00 $2,257.00 $2,302.05 11/2023 Statement Totals: 11/06/2023 ;CHECKscan Payment Cudjoe, ShyrL (90312668) 8770 11/06/2023 $0.00 $0.00 $0.00 $0.05 Reversed by ch# 874907 Voucher No.: ACH/Y9 Deposit 11/10/2023 Reverse receipt Ch# 873532 Cudjoe, ShyrL (90312668) 8770 11/10/2023 $2,350.00 $0.00 $2,350.05 Check Processing Fee Cudjoe, ShyrL (90312668) 11/10/2023 - 11/10/2023 1 $25.00 $0.00 $25.00 $2,327.05 11/10/2023 NSF/Returned Check Fee Cudjoe, ShyrL (90312668) 11/10/2023 - 11/10/2023 1 $25.00 $0.00 $25.00 $2,327.05 11/10/2023 Late Fees Cudjoe, ShyrL (90312668) 11/10/2023 - 11/10/2023 1 $115.25 $0.00 $115.25 $2,467.30 11/13/2023 ;CHECKscan Payment Cudjoe, ShyrL (90312668) 7004139811 11/13/2023 $0.00 $0.00 $0.00 $0.30 Voucher No.: ACH/Y9 Deposit Cudjoe, ShyrL (90312668) 11/20/2023 Check Processing Fee Cudjoe, ShyrL (90312668) 12/01/2023 - 12/31/2023 1 $25.00 $0.00 $25.00 $25.30 Independent Living Rent Cudjoe, ShyrL (90312668) 12/01/2023 - 12/31/2023 1 $2,257.00 $0.00 $2,257.00 $2,282.30 12/2023 Statement Totals: 01/2024 Credit Card One Time Cudjoe, ShyrL (90312668) 218392766 12/11/2023 $(2,487.00) $0.00 $2,447.25 $2,282.30 Payment* - Paid By ShyrL Cudjoe (90312668) ; Voucher Cudjoe (90312668) 12/11/2023 Credit Card One Time Cudjoe, ShyrL (90312668) 218392903 12/11/2023 $0.00 $0.00 $0.00 $952.30 Payment - Paid By ShyrL Cudjoe (90312668) ; Voucher No.: CC Deposit 12/11/2023 Check Processing Fee Cudjoe, ShyrL (90312668) 12/1/1/2023 - 12/11/2023 1 $25.00 $0.00 $25.00 $(1,100.00) Late Fees Cudjoe, ShyrL (90312668) 12/1/1/2023 - 12/11/2023 1 $111.60 $0.00 $111.60 $(122.70) 12/11/2023 Check Processing Fee Cudjoe, ShyrL (90312668) 12/1/1/2023 - 12/1/2023 1 $(25.00) $0.00 $(25.00) $(167.70) Late Fees Cudjoe, ShyrL (90312668) 12/1/2023 - 12/1/2023 1 $111.60 $0.00 $111.60 $(36.10) 12/20/2023 Check Processing Fee Cudjoe, ShyrL (90312668) 01/01/2024 - 01/31/2024 1 $25.00 $0.00 $25.00 $(75.50) Independent Living Rent Cudjoe, ShyrL (90312668) 01/01/2024 - 01/31/2024 1 $2,257.00 $0.00 $2,257.00 $100.50 12/2023 Statement Totals: $(2,430.00) $(25.00) $2,530.20 $2,357.50 02/2024 01/05/2024 Credit Card One Time Cudjoe, ShyrL (90312668) 221861193 01/05/2024 $(707.50) $0.00 $0.00 $1,650.00 Payment - Paid By ShyrL Cudjoe (90312668) ; Voucher No.: CC Deposit 01/05/2024 ;CHECKscan Payment Cudjoe, ShyrL (90312668) 700470613 01/05/2024 $(1,650.00) $0.00 $0.00 $0.00 01/19/2024 Check Processing Fee Cudjoe, ShyrL (90312668) 02/01/2024 - 02/29/2024 1 $25.00 $0.00 $25.00 $25.00 Independent Living Rent Cudjoe, ShyrL (90312668) 02/01/2024 - 02/29/2024 1 $2,257.00 $0.00 $2,257.00 $2,282.00 Statement Totals: $(2,357.50) $0.00 $2,282.00 $2,282.00 Elison of Statesman Club (0kcy) Cudjoe, Shryl (00022946) Statement <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check Number</th> <th>Effective</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>03/13/2024</td> <td>Credit Card One Time<br>Payment: Paid By Shryl</td> <td>Cudjoe, Shryl (90312668)</td> <td>226874446</td> <td>02/13/2024</td> <td></td> <td></td> <td>$2,282.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td></td> <td>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>02/21/2024</td> <td>Check Processing Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>03/01/2024 - 03/31/2024</td> <td>1</td> <td>$25.00</td> <td>$0.00</td> <td>$25.00</td> <td>$0.00</td> <td>$25.00</td> </tr> <tr> <td>02/21/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>03/01/2024 - 03/31/2024</td> <td>1</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,257.00</td> <td>$0.00</td> <td>$2,282.00</td> </tr> <tr> <th colspan="11">03/2024 Statement Totals:</th> </tr> <tr> <td>04/01/2024</td> <td>Check Processing Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>03/01/2024 - 03/31/2024</td> <td>1</td> <td>$25.00</td> <td>$0.00</td> <td>$25.00</td> <td>$0.00</td> <td>$2,257.00</td> </tr> <tr> <td>03/04/2024</td> <td>Check Processing Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/01/2024 - 02/29/2024</td> <td>1</td> <td>$25.00</td> <td>$0.00</td> <td>$25.00</td> <td>$0.00</td> <td>$2,232.00</td> </tr> <tr> <td>03/04/2024</td> <td>Credit Card One Time<br>Payment: Paid By Shryl</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/01/2024 - 01/31/2024</td> <td>1</td> <td>$25.00</td> <td>$0.00</td> <td>$25.00</td> <td>$0.00</td> <td>$2,207.00</td> </tr> <tr> <td>03/04/2024</td> <td>Credit Card One Time<br>Cudjoe, Shryl (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td></td> <td>03/04/2024</td> <td></td> <td></td> <td></td> <td>$2,250.00</td> <td>$0.00</td> <td>$43.00</td> </tr> <tr> <td>03/21/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>04/01/2024 - 04/30/2024</td> <td>1</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,528.00</td> <td>$2,485.00</td> <td></td> </tr> <tr> <th colspan="2">04/2024 Statement Totals:</th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th>$2,250.00</th> <th>$75.00</th> <th>$2,528.00</th> <th>$2,495.00</th> </tr> <tr> <td>04/06/2024</td> <td>Credit Card One Time<br>Payment: Paid By Shryl<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>234998746</td> <td>04/06/2024</td> <td></td> <td></td> <td></td> <td>$2,525.00</td> <td>$0.00</td> <td>$2,498.00</td> <td>$2,495.00</td> </tr> <tr> <td>04/13/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>05/01/2024 - 05/31/2024</td> <td>1</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,498.00</td> <td></td> </tr> <tr> <th colspan="2">05/2024</th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> </tr> <tr> <td>05/16/2024</td> <td>Late Fees</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>05/12/2024 - 05/12/2024</td> <td>1</td> <td>$124.40</td> <td>$0.00</td> <td>$124.40</td> <td>$0.00</td> <td>$3,840.40</td> <td></td> </tr> <tr> <td>05/17/2024</td> <td>Credit Card One Time<br>Payment: Paid By Shryl<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>240288843</td> <td>05/17/2024</td> <td></td> <td>$1,300.00</td> <td>$0.00</td> <td>$1,300.00</td> <td>$0.00</td> <td>$3,840.40</td> <td></td> </tr> <tr> <td>05/22/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>06/01/2024 - 06/30/2024</td> <td>1</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,498.00</td> <td></td> </tr> <tr> <th colspan="2">06/2024 Statement Totals:</th> <th></th> <th></th> <th></th> <th></th> <th></th> <th></th> <th>$1,300.00</th> <th>$0.00</th> <th>$2,528.40</th> <th>$3,840.40</th> </tr> <tr> <td>05/23/2024</td> <td>Credit Card One Time<br>Payment: Paid By Shryl<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>240688080</td> <td>05/23/2024</td> <td></td> <td>$1,188.00</td> <td>$0.00</td> <td>$1,188.00</td> <td>$0.00</td> <td>$2,652.40</td> <td></td> </tr> <tr> <td>05/23/2024</td> <td>Credit Card One Time<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>240681060</td> <td>05/23/2024</td> <td></td> <td>$100.00</td> <td>$0.00</td> <td>$100.00</td> <td>$0.00</td> <td>$2,552.40</td> <td></td> </tr> <tr> <td>06/04/2024</td> <td>Debit Card One Time<br>Payment: Paid By Shryl<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>243245205</td> <td>06/04/2024</td> <td></td> <td>$500.00</td> <td>$0.00</td> <td>$500.00</td> <td>$0.00</td> <td>$2,052.40</td> <td></td> </tr> <tr> <td>06/07/2024</td> <td>Debit Card One Time<br>Cudjoe (90312668); Voucher<br>No.: CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>243894935</td> <td>06/07/2024</td> <td></td> <td>$700.00</td> <td>$0.00</td> <td>$700.00</td> <td>$0.00</td> <td>$1,352.40</td> <td></td> </tr> </table> Resident Detail Ledger Elson of Statesman Club (okcy) Cudjoe, Shyrl (090322946) Statement Date Description Payer Check Number Effective Date Quantity Rate Payments Credits Charges Balance 06/21/2024 Independent Living Rent Cudjoe, Shyrl (90312668) 07/01/2024 - 07/31/2024 1 $2,528.00 $0.00 $2,528.00 $0.00 $3,880.40 08/2024 Statement Totals: 07/08/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 248245473 07/08/2024 $12,488.00 $0.00 $2,528.00 $3,880.40 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' $7,000.00 $0.00 $3,180.40 07/08/2024 Debit Card One Time Cudjoe, Shyrl (90312668) 248245592 07/08/2024 ($350.00) $0.00 $2,830.40 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 07/12/2024 Late Fees Cudjoe, Shyrl (90312668) 07/06/2024 - 07/06/2024 1 $187.80 $0.00 $187.80 $3,018.20 07/18/2024 Independent Living Rent Cudjoe, Shyrl (90312668) 08/01/2024 - 08/31/2024 1 $2,528.00 $0.00 $2,528.00 $5,546.20 08/2024 Statement Totals: 07/25/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 249541285 07/25/2024 ($1,050.00) $0.00 $1,050.00 $5,496.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 07/26/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 299684724 07/26/2024 ($1,000.00) $0.00 $3,496.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 07/29/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 249916586 07/29/2024 $1,000.00 $0.00 $4,496.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 08/01/2024 Debit Card One Time Cudjoe, Shyrl (90312668) 251009363 09/01/2024 ($300.00) $0.00 $2,196.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 08/05/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 252252401 08/05/2024 ($200.00) $0.00 $1,996.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 08/12/2024 Late Fees Cudjoe, Shyrl (90312668) 08/05/2024 - 08/05/2024 1 $94.20 $0.00 $94.20 $2,090.40 08/12/2024 Credit Card One Time Cudjoe, Shyrl (90312668) 253020902 08/12/2024 ($2,090.20) $0.00 $0.20 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' 08/22/2024 Independent Living Rent Cudjoe, Shyrl (90312668) 09/01/2024 - 09/30/2024 1 $2,528.00 $0.00 $2,528.00 $2,528.20 09/2024 Statement Totals: Late Fees Cudjoe, Shyrl (90312668) 09/05/2024 - 09/05/2024 1 $126.40 $0.00 $126.40 $2,654.60 Credit Card One Time Cudjoe, Shyrl (90312668) 257729239 09/10/2024 ($1,000.00) $0.00 $1,654.60 Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: 'CC Deposit' <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check Number</th> <th>Effective</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>09/19/2024</td> <td>Credit Card One Time Payment: Paid By Shyrl Cudjoe (90312668) ; Reversed by crtf# 1095176 ; Payment disputed. Recent automatically NSF'd. Voucher No.: ICC Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>257853050</td> <td>09/19/2024</td> <td></td> <td>$1,700.00</td> <td>$0.00</td> <td>$0.00</td> <td>$1,700.00</td> <td>$1,454.40</td> </tr> <tr> <td colspan="11"><b>10/2/2024 Statement Totals:</b></td> </tr> <tr> <td>10/04/2024</td> <td>Credit Card One Time Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: ICC Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>260633559</td> <td>10/04/2024</td> <td></td> <td>$1,600.00</td> <td>$0.00</td> <td>$0.00</td> <td>$1,600.00</td> <td>$882.60</td> </tr> <tr> <td>10/04/2024</td> <td>Credit Card One Time Payment: Paid By Shyrl Cudjoe (90312668) ; Voucher No.: ICC Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>260635976</td> <td>10/04/2024</td> <td></td> <td>($82.60)</td> <td>$0.00</td> <td>$0.00</td> <td>$400.00</td> <td></td> </tr> <tr> <td>10/21/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shyrl (90312668)</td> <td>10/01/2024 - 11/30/2024</td> <td>1</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,528.00</td> <td>$2,528.00</td> <td>$2,482.60</td> </tr> <tr> <td colspan="11"><b>11/1/2024 Statement Totals:</b></td> </tr> <tr> <td>11/03/2024</td> <td>Pre-Authorized Payment Reverse by crtf# 10-88200 Voucher No.: :ACH/X9 Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/03/2024</td> <td></td> <td>$2,082.60</td> <td>$0.00</td> <td>$2,528.00</td> <td>$2,528.00</td> <td>$2,928.00</td> </tr> <tr> <td>11/07/2024</td> <td>Reverse receipt Crtf# 1054673</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/07/2024</td> <td></td> <td>$2,928.00</td> <td>$0.00</td> <td>$2,928.00</td> <td>$2,928.00</td> <td>$0.00</td> </tr> <tr> <td>11/08/2024</td> <td>One Time EFT Receipt. EFT Payment Paid by Payer: Shyrl Cudjoe (90312668). Reversed by crtf# 1060004 Voucher No.: :ACH/X9 Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/01/2024 - 12/31/2024</td> <td>1</td> <td>$2,928.00</td> <td>$0.00</td> <td>$2,928.00</td> <td>$2,928.00</td> <td>$0.00</td> </tr> <tr> <td>11/15/2024</td> <td>Reverse receipt Crtf# 1058731</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/15/2024</td> <td></td> <td>$2,928.00</td> <td>$0.00</td> <td>$2,928.00</td> <td>$2,928.00</td> <td>$0.00</td> </tr> <tr> <td>11/21/2024</td> <td>NSF/Returned Check Fee</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/07/2024 - 11/07/2024</td> <td>2</td> <td>$25.00</td> <td>$0.00</td> <td>$50.00</td> <td>$2,978.00</td> <td>$3,126.90</td> </tr> <tr> <td>11/21/2024</td> <td>Late Fees</td> <td>Cudjoe, Shyrl (90312668)</td> <td>11/06/2024 - 11/06/2024</td> <td>1</td> <td>$198.90</td> <td>$0.00</td> <td>$198.90</td> <td>$3,126.90</td> <td>$5,654.90</td> </tr> <tr> <td>11/21/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shyrl (90312668)</td> <td>12/01/2024 - 12/31/2024</td> <td>1</td> <td>$2,528.00</td> <td>$0.00</td> <td>$2,528.00</td> <td>$2,528.00</td> <td>$5,654.90</td> </tr> <tr> <td colspan="11"><b>12/2/2024 Statement Totals:</b></td> </tr> <tr> <td>01/21/2024</td> <td>Credit Card One Time Payment: Paid By Shyrl Cudjoe (90312668) ; Reversed by crtf# 1095172 ; Payment disputed. Receipt automatically NSF'd. Voucher No.: ICC Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>261155301</td> <td>11/21/2024</td> <td></td> <td>$3,200.00</td> <td>$0.00</td> <td>$0.00</td> <td>$2,454.90</td> <td></td> </tr> <tr> <td>12/03/2024</td> <td>Pre-Authorized Payment Reverse by crtf# 1075241 Voucher No.: :ACH/X9 Deposit</td> <td>Cudjoe, Shyrl (90312668)</td> <td>12/03/2024</td> <td></td> <td>($2,454.90)</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$2,454.90</td> <td></td> </tr> <tr> <td>12/06/2024</td> <td>Reverse receipt Crtf# 1071117</td> <td>Cudjoe, Shyrl (90312668)</td> <td>12/06/2024</td> <td></td> <td>$2,454.90</td> <td>$0.00</td> <td>$0.00</td> <td>$2,454.90</td> <td></td> <td></td> </tr> </table> Elison of Statesman Club (0kvy) Cudjoe, Shryl (00022946) Statement <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check</th> <th>Effective</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>12/10/2024</td> <td>One Time EFT Receipt: EFT Payment Paid by Payer: Shryl Cudjoe (90312668), Reversed By: ctr# 1078070 Voucher No: ;ACH/X9 Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td>;ACH+472319</td> <td>12/10/2024</td> <td></td> <td>$2,454.50</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>12/11/2024</td> <td>Late Fees</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>12/09/2024 - 12/19/2024</td> <td>1</td> <td>$12.23</td> <td>$0.00</td> <td>$0.00</td> <td>$123.00</td> <td>$132.00</td> </tr> <tr> <td>12/11/2024</td> <td>NSF/Returned Check Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>12/06/2024 - 12/06/2024</td> <td>1</td> <td>$50.00</td> <td>$0.00</td> <td>$50.00</td> <td>$173.00</td> <td>$173.00</td> </tr> <tr> <td>12/16/2024</td> <td>Reverse Receipt Ctrl# 1076928</td> <td>Cudjoe, Shryl (90312668)</td> <td>;ACH+472319</td> <td>12/16/2024</td> <td></td> <td>$2,454.90</td> <td>$0.00</td> <td>$0.00</td> <td>$2,627.90</td> <td>$2,627.90</td> </tr> <tr> <td>12/19/2024</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/01/2025 - 01/31/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$5,322.90</td> <td>$5,322.90</td> </tr> <tr> <th colspan="11">02/2025 Statement Totals:</th> <th colspan="2">$13,200.00</th> <th>$0.00</th> <th>$2,868.00</th> <th>$5,322.90</th> </tr> <tr> <td>01/03/2025</td> <td>Pre-Authorized Payment</td> <td>Cudjoe, Shryl (90312668)</td> <td>;ACH+477660</td> <td>01/03/2025</td> <td></td> <td>$5,322.90</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,322.90</td> </tr> <tr> <td></td> <td>Reversed by ctrl# 1094006</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>01/08/2025</td> <td>Voucher No.; ACH/X9 Deposit Reverse receipt Ctrl# 1089851</td> <td>Cudjoe, Shryl (90312668)</td> <td>;ACH+477660</td> <td>01/08/2025</td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,322.90</td> <td>$5,322.90</td> </tr> <tr> <td>01/10/2025</td> <td>NSF/Returned Check Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/09/2025 - 01/09/2025</td> <td>1</td> <td>$25.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,347.90</td> <td>$5,347.90</td> </tr> <tr> <td>01/10/2025</td> <td>Late Fees</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/09/2025 - 01/09/2025</td> <td>1</td> <td>$0.00</td> <td>$268.64</td> <td>$0.00</td> <td>$5,616.54</td> <td>$5,616.54</td> </tr> <tr> <td>01/13/2025</td> <td>Reverse receipt Ctrl# 1061441</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/13/2025</td> <td></td> <td>$3,200.00</td> <td>$0.00</td> <td>$0.00</td> <td>$8,816.54</td> <td>$8,816.54</td> </tr> <tr> <td>01/13/2025</td> <td>Reverse receipt Ctrl# 1025332</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/13/2025</td> <td></td> <td>$1,700.00</td> <td>$0.00</td> <td>$0.00</td> <td>$10,516.54</td> <td>$10,516.54</td> </tr> <tr> <td>01/14/2025</td> <td>NSF/Returned Check Fee</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>01/14/2025 - 01/14/2025</td> <td>1</td> <td>$0.00</td> <td>$100.00</td> <td>$0.00</td> <td>$10,616.54</td> <td>$10,616.54</td> </tr> <tr> <td>01/22/2025</td> <td>Independent Living Rent</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/01/2025 - 02/28/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$13,311.54</td> <td>$13,311.54</td> </tr> <tr> <th colspan="10">02/2025 Statement Totals:</th> <th colspan="2">$44,900.00</th> <th>$0.00</th> <th>$3,088.64</th> <th>$13,311.54</th> </tr> <tr> <td>02/01/2025</td> <td>;CHECKscan Payment</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/01/2025</td> <td></td> <td>$(900.00)</td> <td>$0.00</td> <td>$0.00</td> <td>$12,411.54</td> <td>$12,411.54</td> </tr> <tr> <td>02/01/2025</td> <td>Voucher No.; ACH/X9 Deposit</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> <td></td> </tr> <tr> <td>02/01/2025</td> <td>;CHECKScan Payment Voucher No.; ACH/X9 Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/01/2025</td> <td></td> <td>$9,000.00</td> <td>$0.00</td> <td>$0.00</td> <td>$3,411.54</td> <td>$3,411.54</td> </tr> <tr> <td>02/01/2025</td> <td>Pre-Authorized Payment</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/01/2025</td> <td></td> <td>$(800.00)</td> <td>$0.00</td> <td>$0.00</td> <td>$2,611.54</td> <td>$2,611.54</td> </tr> <tr> <td>02/03/2025</td> <td>;CHECKscan Payment Reversed by ctrl# 1112197</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/03/2025</td> <td></td> <td>$(2,611.54)</td> <td>$0.00</td> <td>$0.00</td> <td></td> <td></td> <td></td> </tr> <tr> <td>02/03/2025</td> <td>Voucher No.; ACH/X9 Deposit</td> <td></td> <td></td> <td></td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td></td> <td></td> <td></td> </tr> <tr> <td>02/03/2025</td> <td>Credit Card : Auto Created Receipt for Dispute won.</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>266155301</td> <td>02/03/2025</td> <td>$3,200.00</td> <td>$0.00</td> <td>$0.00</td> <td>$3,200.00</td> <td>$3,200.00</td> </tr> <tr> <td>02/07/2025</td> <td>Voucher No.; CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>02/07/2025</td> <td></td> <td>$2,611.54</td> <td>$0.00</td> <td>$0.00</td> <td>$(588.46)</td> <td>$(588.46)</td> </tr> <tr> <td>1108115</td> <td></td> <td></td> <td></td> <td>02/07/2025</td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$(2,288.46)</td> <td>$(2,288.46)</td> </tr> <tr> <td>02/07/2025</td> <td>Credit Card : Auto Created Receipt for Dispute won. Voucher No.; CC Deposit</td> <td>Cudjoe, Shryl (90312668)</td> <td></td> <td>257853050</td> <td>02/07/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr Elison of Statesman Club (okcy) Cudjoe, Shmyl (00022946) Statement <table> <tr> <th>Date</th> <th>Description</th> <th>Payer</th> <th>Check Number</th> <th>Effective</th> <th>Quantity</th> <th>Rate</th> <th>Payments</th> <th>Credits</th> <th>Charges</th> <th>Balance</th> </tr> <tr> <td>04/7/2025</td> <td>Pre-Authorized Payment<br>Voucher No.: ;ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-493374</td> <td>03/03/2025</td> <td>$406.54</td> <td>$406.54</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>03/03/7/2025</td> <td>Reversed by chrt# 1128991</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td></td> </tr> <tr> <td>03/06/7/2025</td> <td>Reverse receipt Chrt# 1125223</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-493374</td> <td>03/06/2025</td> <td>$406.54</td> <td>$406.54</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$406.54</td> </tr> <tr> <td>03/06/7/2025</td> <td>;CHECKScan Payment</td> <td></td> <td></td> <td></td> <td></td> <td></td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$133.46</td> </tr> <tr> <td>03/06/7/2025</td> <td>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>91610311071</td> <td>03/06/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$133.46</td> <td>$133.46</td> </tr> <tr> <td>03/16/2025</td> <td>Meal Delivery Fee</td> <td>Cudjoe, Shmyl (90312668)</td> <td>03/16/2025 - 03/16/2025</td> <td>1</td> <td>$0.00</td> <td>$5.00</td> <td>$0.00</td> <td>$5.00</td> <td>$28.46</td> <td>$28.46</td> </tr> <tr> <td>03/17/2025</td> <td>Independent Living Rent</td> <td>Cudjoe, Shmyl (90312668)</td> <td>04/01/2025 - 04/30/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,666.54</td> <td>$2,666.54</td> </tr> </table> <table> <tr> <th colspan="10">04/30/2025 Statement Totals:</th> </tr> <tr> <td>04/03/7/2025</td> <td>Pre-Authorized Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-501634</td> <td>04/03/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$2,666.54</td> <td>$0.00</td> <td>$2,666.54</td> </tr> <tr> <td>04/08/7/2025</td> <td>Reverse receipt Chrt# 1144850</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-501634</td> <td>04/08/2025</td> <td>$2,666.54</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$2,666.54</td> </tr> <tr> <td>04/14/7/2025</td> <td>Late Fees</td> <td>Cudjoe, Shmyl (90312668)</td> <td>04/05/2025 - 04/05/2025</td> <td>1</td> <td>$133.33</td> <td>$0.00</td> <td>$133.33</td> <td>$2,799.87</td> <td>$2,799.87</td> </tr> <tr> <td>04/18/7/2025</td> <td>Independent Living Rent</td> <td>Cudjoe, Shmyl (90312668)</td> <td>05/01/2025 - 05/31/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$5,494.87</td> <td>$5,494.87</td> </tr> </table> <table> <tr> <th colspan="10">05/2025 Statement Totals:</th> </tr> <tr> <td>05/03/7/2025</td> <td>Pre-Authorized Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-509712</td> <td>05/03/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>05/08/7/2025</td> <td>Reverse receipt Chrt# 1163351</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-509712</td> <td>05/08/2025</td> <td>$5,494.87</td> <td>$0.00</td> <td>$0.00</td> <td>$5,494.87</td> <td>$5,494.87</td> </tr> <tr> <td>05/18/2025</td> <td>Independent Living Rent</td> <td>Cudjoe, Shmyl (90312668)</td> <td>06/01/2025 - 06/30/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$8,189.87</td> </tr> </table> <table> <tr> <th colspan="10">06/2025 Statement Totals:</th> </tr> <tr> <td>05/30/7/2025</td> <td>;CHECKScan Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>91610311689</td> <td>05/30/2025</td> <td>$2,400.00</td> <td>$0.00</td> <td>$0.00</td> <td>$5,789.87</td> <td>$8,189.87</td> </tr> <tr> <td>05/30/7/2025</td> <td>;CHECKScan Payment</td> <td>Cudjoe, Shmyl (90312668)</td> <td>9161014152</td> <td>05/30/2025</td> <td>$500.00</td> <td>$0.00</td> <td>$5,289.87</td> <td>$0.00</td> <td>$5,289.87</td> </tr> <tr> <td>06/03/7/2025</td> <td>Pre-Authorized Payment</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-517509</td> <td>06/03/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> <td>$0.00</td> </tr> <tr> <td>06/06/7/2025</td> <td>Reversed by chrt# 1183958<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>:ACH-517509</td> <td>06/06/2025</td> <td>$5,289.87</td> <td>$0.00</td> <td>$0.00</td> <td>$5,289.87</td> <td>$5,289.87</td> </tr> <tr> <td>06/17/7/2025</td> <td>Independent Living Rent</td> <td>Cudjoe, Shmyl (90312668)</td> <td>07/01/2025 - 07/31/2025</td> <td>1</td> <td>$2,695.00</td> <td>$0.00</td> <td>$2,695.00</td> <td>$7,984.87</td> <td>$7,984.87</td> </tr> </table> <table> <tr> <th colspan="10">07/2025 Statement Totals:</th> </tr> <tr> <td>07/01/7/2025</td> <td>;CHECKScan Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>402209777647</td> <td>07/01/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$6,984.87</td> <td>$6,984.87</td> <td>$6,984.87</td> </tr> <tr> <td>07/01/7/2025</td> <td>;CHECKScan Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>402209777647</td> <td>07/01/2025</td> <td>$1,000.00</td> <td>$0.00</td> <td>$5,984.87</td> <td>$5,984.87</td> <td>$5,984.87</td> </tr> <tr> <td>07/01/7/2025</td> <td>;CHECKScan Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>402209777647</td> <td>07/01/2025</td> <td>$0.00</td> <td>$0.00</td> <td>$4,984.87</td> <td>$4,984.87</td> <td>$4,984.87</td> </tr> <tr> <td>07/01/7/2025</td> <td>;CHECKScan Payment<br>Voucher No.; :ACH/X9 Deposit</td> <td>Cudjoe, Shmyl (90312668)</td> <td>402209777647</td> <td>07/01/2025</td> <td>$1,000.00</td> <td>$0.00</td> <td>$3,984.87</td> <td>$3,984.87</td> <td>$3,984.87</td> </tr> </table> Elison of Statesman Club (oky) Cudjoe, Shnyl (00022946) Statement Date | Description | Payer | Check Number | Effective Quantity | Rate | Payments Credits | Charges Balance 07/01/2025 :CHECKscan Payment Cudjoe, Shnyl (90312668) 401976021669 $19,484.87 07/01/2025 Voucher No.:ACH/X9 Deposit 26 07/01/2025 :CHECKscan Payment Cudjoe, Shnyl (90312668) 401976021669 $(98,000) Voucher No.:ACH/X9 Deposit 17 $0.00 $2,986.87 07/01/2025 :CHECKscan Payment 402209777647 $2,286.87 Voucher No.:ACH/X9 Deposit 88 $0.00 07/05/2025 Late Fees Cudjoe, Shnyl (90312668) 07/05/2025 - 07/05/2025 1 $107.68 $0.00 $2,286.87 07/21/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 08/01/2025 - 08/31/2025 1 $2,695.00 $0.00 $2,286.87 08/2025 Statement Totals: $(15,698.00) $0.00 $2,802.68 $5,089.55 07/29/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 08/01/2025 - 08/31/2025 1 $2,695.00 $0.00 $2,802.68 07/29/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 08/01/2025 - 08/31/2025 1 $2,695.00 $0.00 $2,802.68 08/02/2025 :CHECKscan Payment Cudjoe, Shnyl (90312668) 3889 $0.00 $2,695.00 $2,802.68 Reversed by chrl# 12/19/18 Voucher No.: CHECKscan Deposit 08/05/2025 Late Fees Cudjoe, Shnyl (90312668) 08/05/2025 - 08/05/2025 1 $145.28 $0.00 $3,050.83 08/06/2025 Reverse receipt Ctrl# Cudjoe, Shnyl (90312668) 08/06/2025 $2,400.00 $0.00 $5,450.83 12/16/288 3889 $2,911.00 $0.00 $2,905.55 08/06/2025 NSF/Returned Check Fee Cudjoe, Shnyl (90312668) 08/06/2025 - 08/06/2025 1 $25.00 $0.00 $5,475.83 08/21/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 09/01/2025 - 09/30/2025 1 $2,911.00 $0.00 $8,386.83 09/2025 Statement Totals: 10/12/25 Late Fees Cudjoe, Shnyl (90312668) 09/05/2025 - 09/05/2025 1 $419.30 $0.00 $8,806.13 09/17/2025 Meal Delivery Fee Cudjoe, Shnyl (90312668) 09/15/2025 - 09/15/2025 2 $5.00 $0.00 $8,811.13 09/17/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 10/01/2025 - 10/31/2025 $0.00 $0.00 $11,772.13 10/2025 Statement Totals: $0.00 $0.00 $3,340.30 $11,772.13 11/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 11/01/2025 - 11/30/2025 $0.00 $0.00 $2,911.00 $14,683.13 11/2025 Statement Totals: $2,911.00 $14,683.13 11/25/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 12/01/2025 - 12/31/2025 1 $2,911.00 $0.00 $17,594.13 12/1/2025 Meal Delivery Fee Cudjoe, Shnyl (90312668) 12/16/2025 - 12/16/2025 5 $.50 $0.00 $17,574.13 12/20/2025 Independent Living Rent Cudjoe, Shnyl (90312668) 01/01/2026 - 01/31/2026 1 $2,911.00 $0.00 $20,485.13 01/2026 Statement Totals: $.00 $.00 $2,913.00 $20,485.13 02/1/2026 Independent Living Rent Cudjoe, Shnyl (90312668) 02/01/2026 - 02/28/2026 1 $2,911.00 $.00 $23,396.13 02/2026 Statement Totals: $.00 $.00 $2,911.00 $23,396.13