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I <br /> l.:(Y LV )ledIlk_KS <br /> i;2)ROMC41.0 BLVD mance <br /> "W MM. O . 974U2.41S9 ' <br /> Sill 682-4812 and Open Space �1 <br /> i eva rd• .`."...,"' <br /> Sale 300 Eugene <br /> 382 <br /> XXXXXXXXXXXX0480 <br /> VISA Entry hethod: Chip RECEIPT <br /> 'Total: 1,157. 6 O ( 4 <br /> 050 4 13:28:3S Bre# s/Q/ ,83J Lac ( 9 gds-3 20 <br /> iappr Code: '1.3; <br /> Inv a: 1,41,11'42 � _ <br /> APPIA: Online I ei4.4DI?) e 7 A 97 3SS <br /> Visa Credit Description Amount <br /> I RID: A0M031010 <br /> IVR: 00 80 00 0000 Crl 7 trrel- k QYMAC �`�— <br /> ISI: f8 00 <br /> I agree to WAY above total a,00unt <br /> according to card issuer a9reesent <br /> ,a (Merchant agreement if credit voucher) <br /> • <br /> X- TOTAL �� <br /> SL A'dDf N-BRITT W <br /> Merchant COPY <br /> THANK YOU! <br /> ;ash 0 Check# redit Card <br /> Received by heat-4- jk-e!,..... <br /> ii <br /> r-r aerie - � 3� <br /> 1 �t - c(O D- '-i5--1 ec ' , 2a i • t 1 <br />