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.max <br /> CITY( EUGENE POS <br /> 1820 ROOSEVELT BLVD <br /> EUGENE, OR. 97902-9159 <br /> 591-6829812 <br /> REPRINT <br /> • Phone Order <br /> xxxxxxxxxzxx§923 <br /> VISA Entry Method: Manual <br /> Total: $ 40.00 <br /> 09/15/17 11:20:09 <br /> Inv 11: ,11,80002 Aper Code: 092019 <br /> fPrvd: Online <br /> AVS Code: <br /> CVV2 Code: MATCH M <br /> I agree to par above total amount <br /> according to card issuer agreement <br /> (Merchant agreement if credit voucher) <br /> xe I3° <br /> Merchant Copy <br /> THAM(YOU! <br />