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Ioa5ig / A- Aer-N <br /> CITY Ct tkftE PENCITY CI UWE PUS <br /> 16126 00%SEVELr BLVD 1827 ROOSEVELT BLVD <br /> ME <br /> LIA . BN. 97402-4159 tlLEk. CR 9741Q-4159 <br /> 541 687 4412 .41 6s2 4812 <br /> R PR NT a a <br /> Phone Order Phone order <br /> ml>oocaxxlxx1969 <br /> MSTERCI Entry Method: Ifanal VISA En:ry method: %na1 <br /> Total: $ 100.00 Total: $ 100.00 <br /> 18/45/18 14:17:24 18'25'18 14:14:49 <br /> Inv II: ;c,vw. floor Code: 57247P Inv <br /> : Online <br /> floor Cade: 244692 <br /> Aoorvd: Online <br /> AVS C : AVS Code: <br /> CW2 Code: NCB h CVY2 Co*: MICA M <br /> I arta to oat above total aapmt <br /> 1 aorta to naw above total await .ccor'dlns to crd Iswer smee.enl <br /> arcading to crd Issuer areeaant 1Berchant aPeeaent Ir crtdrl veuchert <br /> (Merchant aareeeent if credit voucher) <br /> X CC— A-01 3 x ( & .4f 02- <br /> - <br /> lit,.t.ad Coo. Merdwd Coos <br /> IIVVI( YOU. IISY4(YWI <br />