e� <br /> s/___Ck 3o3fl <br /> RE•RIN ' P'INT <br /> beak 111. 1383 n..• i0 I:83 <br /> 14<dont ID: 1251 6..I....t 10. 1551 <br /> rae ID: eat Tele ID: 601 <br /> LIN IN taint WS Sale Phone Order <br /> 10114 30111 AVE SIC AW <br /> Mi1lt. <br /> 6 2 5671 Aglakrile yy�Y0yy�yyy1'y�(.���yyyyyy <br /> !15.01,19 23:01:66 VISA Ener;Ikthod: Clem V1S0 Entry Chi: shoal <br /> PIKS REMi Total: $ 75.00 Total: $ 100.00 <br /> UNP! 64349 10:52:53 <br /> luta' Inv fl: kw Code: 816458 <br /> Eed Ca0.10 lnv q; ;60119 11:11:16 s;,,. kyr Collo: 00'3324 <br /> 35 5 3w.� 366.66 Pond: Online Nicht 12391 <br /> 303.03 APS: Online IMP: ' CY02 Code: If41CH N <br /> isle total; <br /> ! 30303 &2111..1 Ike.. a0twuui <br /> N<J uv.1 kef.11: IVII.MI'e <br /> I .alt tv oar about total .wont <br /> accoNuw to tad natter avrtt.ent I twin to var above tote) awun! <br /> Merchant aret.ent ti credit vaueherl arca-dine to cad ince .rree.ent <br /> X \y\/(�IJ�1r�/ (Merchant <br /> (.rr.nent if credit vaccine) <br /> 11 fY 9 LAVE S POS t I- -- (I -� y / `i/ "^S <br /> 1110 4 I?I4 AVE 51F 9tA1 SIL VIRlA%APIC A X._ �-..------- <br /> (541E. 2 08101 VISA t.iSitI <br /> e5V11 taYL'Sa77 AID: AB01U0JJJs1J10 <br /> 151: 6606 Ilei.Ibnt Car <br /> lee Its: 601 IVR. OW011080W <br /> 6413,13 <br /> 23:02:12 Ilord.mt Cour <br /> SE1111EIDl1 FOCRI <br /> Batch Ma: 123031 <br /> Wit IWe: VR$V <br /> lies clod: 1 <br /> S 3130.03 <br /> ,seal : 5 $ 36e.w REPRINT ' Psi R P'IN <br /> Seitlelrnt Successful �* ED: 1383 1,). I4: lA nv 10: 1183 <br /> r J+nt IV: uel arvi:I : I0: 1 L <br /> Ike-chant ID: 1251. .,e ID: WI las ID: 001 <br /> Tare ID: 601 <br /> Phone Order Phone Order Phone Order <br /> :I;i:(400711111005 =112.1: U1;CVd'IAX114832 <br /> • Entre&thud: Manual ;9p Entre Method: Ik Y1Sp Entry Nethod: Malo <br /> H 100.00 25.0 <br /> Total: `otal: $ 60- Total: $ <br /> 65n1'✓19 <br /> 10:50:11 v8"yN 19:5 ifyisYl9 10:51 <br /> 75•,3 + Inv tl: 6013181 Par Cede: 348077 Iv is Bf>nfl knr Code: el Inv N: 0203 kw Code: <br /> Oes <br /> Batchp: 12 061 : Oalire 8atd : Il Amid, Online Batctil: 123 <br /> • <br /> Povrvd: Online 012 Cede: NM fl <br /> 75 ; * (.12 Cale: M 102 Code: M4ICH M <br /> Art,teal Ref <br /> J. NaltllNDl • <br /> Lciersl 4.f.11 54100r1.11 Revival 40!.11: w1Ueh`3 <br /> . '):J + .[o<e lois! .twt.d 1 Met to var thcNC tate! yWunt I agree to vat above total .nt <br /> 1 oat to l nclunnt °�Ko rrfie <br /> • <br /> rZtJ•J� + xcerdtro jI'�aa�� nstttr .rree.tnt (Merchant <br /> to card na�<' arca-dins to <br /> t if dlt <br /> 111:ch.nt aEr aaQ�credtt avcMrl lMec'tNnt MNardntc�t��f,Jy1e,/11r/e]�do v:veM'�� <br /> Merchant a✓ 'rJ1L)`//fir <br /> • <br /> 504 3 <br /> z85 7 * 11...1...l 0.01, Bo.iunt Cove <br /> Ms..144.i COP? <br /> 3. * <br /> 75 '^ <br /> •JJ + <br /> 265• ' 1 <br /> _ p02. . . . . <br /> r,. <br />