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117L _ ___ q ii)/3 /116 <br /> (il, N L,,W. ru <br /> 1820 ROOSEVELT BLVD <br /> CITY 0r EUGENE NOS EUGENE. OR. 97402-4159 <br /> 1E20 lt60s4EVELT BLVD 541-602.9812 <br /> tlluEti5. -6. 97402-4159 REPRINT <br /> 591-t;b2-9a12 <br /> 18'8 ROIITISE ELT BLVD REPRINT <br /> EUGENE. OR. 97402-4159 • <br /> one A rder <br /> 541682-4812 <br /> ,y..l:;;lc 22:32:03 Phone"Order zzzzxzzxzzzz4999 <br /> TOTALS REPORT xxxxxxxxxxxx3182 VISA Entry Method: Manual <br /> Elation <br /> VISA Entry Method: Manual Total: $ 15.00 <br /> Carl Cot Sole Waw Total Total: $ 75.00 0901,,16 15:1218 <br /> VI 2 90.00 0.00 90.00 8S'13/16 608;06 Inv 4: 000000002 Apar Code: 842310 <br /> Sale Total: $ 90.01 Inu II: Fisc' 14,4Apar Code: 890880 Aaarvd: Online <br /> Total: 90 Ou <br /> ApprYd: Online AVS Code: AOOR MATCH A <br /> AVS Code: MO MATCH N CVV2 Code: MATCH M <br /> CVV2 Code: MATCH M I agree nar abo•,e total amount <br /> accord'no to card issuer aereement <br /> iMerclant aereement if credit voucher) <br /> I agree to oar above total amount <br /> accordiwg <br /> Merchant ifs eoa <br /> oreement <br /> /Mit vouch.,,) <br /> D,"'2 <br /> C11V 01 EUGENE NOS IIiRNh YOU' <br /> 1320 1004CVt.LT BLVD Me,<i.n.t f. ur <br /> FUSC:IE. OR. 97402-4159 <br /> 541 68 2-4812 <br /> 4812 1IWI4 'gilt <br /> 17%11 Ib 2..2:35:15 <br /> SETTLEMENT REPORT <br /> Bahl, Num: 204 , <br /> Hoot Name. El;, .,m <br /> ikr.hont: 1 (‘ <br /> � . 0. :,e <br /> ialv.- m.onn $ 91.00 , O e. <br /> Total '/°% <br /> 2 $ .- 9)1.00 '' 75.00 + <br /> Settlement Succesmfui 001..o•..o, .. <br /> 0808204:19140133 75•Q0 * <br /> 0• * <br /> Q,- <br /> 15.00 + <br /> 001..0.300, <br /> 0. * <br /> 75.00 + <br /> 15.00 + <br /> 0020)000,,,,,0.0.. <br /> 90.00 *1 <br /> L.' ;X•SSP•..... ;.:-..,:Y. Y'i. :Y" .. } Y ', psi t 4,y..4 SI_:r".:;.4. .,e-.'`as`rc..,.i:,::f. ;.t. ............ ... . <br />