. <br /> ii - - ----- <br /> Clin lux(It. Hilt <br /> iti^c R001:E,EL1 B1 VII <br /> LOC*Ie. ill .Whit-11:.;1 <br /> 541 6d2 4e12 <br /> • <br /> Uc 41.16 22:32:02 <br /> IUIS RI,ONRT i • <br /> Elavon <br /> L.1 d Chi Sale Pram, Iota! CITY iii til(iEIIL PUSl i'� Ut [WINE PUS <br /> 1820 hCtltaEVLi i til VU 1820 ROUSLVELT BLVD <br /> itnIEME OR. 97403-41b9 Ehf,ENE, OR. 97102-41b9 <br /> VI 1 .W.00 0.06 40.00 ¶4i 602-4412 541-6'.."-9812 <br /> MC 1 10r4.00 ii.ui+ lUS.LiU aillalati <br /> Sala LW: $ 115.15.IFl REPRINT': <br /> NAM. $ 1 <br /> Phone -Or�4y r`. • <br /> � s ha' a .tJr�-cfer`-:-=:: <br /> xxxxxxxxxxxx7292 H xxxxxxxxxxxx9158 <br /> :4 • MASIERCARD Entry.Method: Manual VISA Entry Method: Manual <br /> (,�� LIIJ 1W I.Ul,tt POS Total: $ 105.00 Tonal: 4x3.s 0 <br /> 1820 ROOSEVELT BLVD <br /> Nark,541.68241812 4159 61.16 15:43:55 i1/16 <br /> 61f8b 1 APPr Code: 111932 ; 811% <br /> • <br /> Inv If; +` Inv a: ,,,,;;;;I AAPr Code: 981190 if <br /> .ei:.16 n:32:10 I APPrid: Online APPrvd: Online <br /> SEIM' 'la'i'r AVS Code: ZIP MATCH 1 AUS Code: ZIP MATCH Z <br /> Batch N.: 17B CVV2 Code: MATCH M { 01/2 Code: MATCH H <br /> Neat Name: Flown' J <br /> • <br /> Merchant: 1 <br /> • I agree to Par abive L & v>a:•.a I avrre to May a:;o <br /> i 10, OB avccdin9 to car•d 1591 M!'aSi1:CheJl ve ioCal amount <br /> 'Sale.:° arrordina to-ard mbuer a'ureement <br /> i,W41 �}ii9MX:'' (Merchant ay:renent if credit votnirer) (Merchant ay.-cement if credit ,'oucheri <br /> Total 2 $ 145 uu <br /> Settlecent SucceS;Tul xJ-teo a ci/zS_ <br /> WOK lrt:086201'32 _ <br /> (krLhanl Co ,' "/C AMat.Iwd PI, Ct __ <br /> 11L4111( ';UU! <br /> DIME YOU, <br /> • <br /> • <br /> 6)6 <br /> 105.00 + <br /> 01 .,o:,... •._. <br /> 105.00 * <br /> 0• <br /> (t\\ ' '40.00 + <br /> 001...,aaa <br /> , 40.0 <br /> • 0. * <br /> 105.00 + , <br /> 40. 0 + <br /> CO2o0aoo0 oe•`•• <br /> 145.00 <br /> AiW;; !4'1 ? 0• * <br /> f yr <br /> oY F, <br />