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THS4521: Conversion of Single Ended Bipolar Signal to Differential Signal Conversion.

Part Number: THS4521
Other Parts Discussed in Thread: THS4561, , THS2630

Tool/software:

Hi TI Team, 

I need a circuit design support for below requirement. 

I have an analog input of Single Ended Bipolar, +/-12V signal. I need to connect that signal to  MPCIE-AIO16-16F module's analog input. As per the module datasheet the below attaching the specification. 
  
So, for establishing this connection, can you suggest circuit for that will convert single ended bipolar (+/-12V) to Differential Bipolar signal.?

Thank you !