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1.114 It LIIt* KS <br /> IVO N 10111,14E SIE iW <br /> tU1EN. 1M 97401 <br /> (541) UO2%77 <br /> W/WIS 21.02'61 ~--•wn••~�. <br /> 1013 REPORT <br /> ,a Mitt PDS <br /> WIN��ttQ IW .11 AVE SIE iW tin' el AVEt5 FOS <br /> lW 11 t0ID aVE Sit Wu <br /> tib.. ..R%'i.l L1t44. tQ%? <br /> 1591. 1.,2,b677T <br /> Card Ent Sale fatal <br /> 0S 2 130.111) 133.00 REPR ` <br /> REPR <br /> Salt 1014: 4 liU.tb <br /> Tata!: t 130.00 Bari 1D: : <br /> terchamt IDID: 161 Wok ID: 1383 <br /> Ter. ID. 001 Merchant ID: 1251 <br /> Tera ID: WI <br /> Phone Order Phone Order <br /> %XtXIIk)OOIX1Omv X1aW OOMIli <br /> WM Ent <br /> are OF FINN PUS <br /> '• Ibnllal WM Entry Ikthod: torml <br /> 100 R 10.111 ME SIE 44X1 <br /> Wei. _i6ii ToTotal.: ' ��1.00 Total: $ 90.00 <br /> ler. W. WI • e5e19 15:36:16 <br /> (ey1,17 2;.W:W { <br /> Inv I: !, :;1 <br /> tar Code: Oi61S8ti19 16:89:31 <br /> ko d: Online <br /> Bacilli 142R1 Inv q: 86 l�sr Code: 3146 <br /> 1 • CI�t2 lode: IkTth II N1u1.M 9)Acrid: Online <br /> ID p B3tchq: 19288! <br /> data.Nu: lent Retrieval Iccf.1. .WIU.UL Ret, Code: 1111117 II <br /> Ilw,t llama: 'MN Re L•leval Ref.11: 3tl41e1id2 <br /> Merdani. I <br /> A la 2 t L <br /> : 1 twee to ear above total amount I agree to oar above total e. m <br /> at <br /> t,. according to ca d lair arreeeent attOCdtto cs'd 1Sa agreement <br /> Total 2 (Merchant agreewmt IF credit vouchera M ar <br /> Merchant agreement if credit voucher) <br /> Settletent Slxcessful )< ilea. 49/IC <br /> p. .1:4 Can <br /> y'f 110:11.0“ CLOY <br /> tlQln'llu ( ICF HOU tIl11Witt' 1Data:ILON <br /> t_� r//I1/4...y...... 90.00 + <br /> i 43.0, + <br /> 002• -4.' <br /> - <br />