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477tne ,/174(74; <br /> r. <br /> /e-CO✓r' — 922_/OD <br /> 14/49r/C l/r r% - 96so <br /> /10J/Q M` - 3/9 ;Apace <br /> Eugene <br /> RECEIPT <br /> Date <br /> From <br /> Address - • <br /> - <br /> City/State/Zip <br /> Quantity Description Amount <br /> TOTAL <br /> Payment: 0 Cash 0 Check# ❑ Credit Card <br /> Received by <br />