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i'I:Y of flint ROS 10ttY . iIXEN* POS <br /> 100 x 10111 AVE STE 4W 410ME SIE400 <br /> MU'OE. tet 97401 11REH. OR 9f481 <br /> (5411 682 5577 • (5411 482-%fl <br /> REPRINT REPR NT <br /> Bra ID: 1383 aux CD: 1983 <br /> le,chant ID: 1251 Merchant TO: 1251 <br /> Tee. 10: 801 Tent ID: 001 <br /> Phone Order Phone Order <br /> VX) 10)00Ca3328 003t7X00001120 • <br /> PISA Entre Method: Renal VISA Entry Method: Manual <br /> Total: $ 100.00 Total: $ 100.00 <br /> 119 13:44:29 1941/13 13:47:43 <br /> Inv 0: ,1:7v pour Code: 860119 leer!: 8d1bU4 Aivr Code: 120556 <br /> paorvd: OnlineBath234081 I UOnl <br /> Bata: 29431 <br /> ROVE Code: Mryl M CYV2 <br /> NMI 11 <br /> Rat.eival Ref.g: .181.10.181i ' R.t.creal Ref e: 961.001)82 <br /> I neerto Par tontotal soon( 1 neve t.Par Arm total a.mmt <br /> according to card issuer aureraentaccording to cad issuer areeunt <br /> rta <br /> (Merchant aeent if credit voucher) (Merchant aree.ent(t if credit wacher) <br /> • <br /> flit 01 EUGENE PIA <br /> 1U0 x 10111 AVE SIE 448 WY Of EUE1E POS <br /> Elites. OR 97401 too x 18111 AVE 511 40U <br /> 1541) 682.5077 Et4Ett. OR 97401 <br /> . 15411 8825877 <br /> REPRINT REPRINT <br /> Baia ID: 1313 <br /> lhechant ID: 1251 Bar. 10: 1383 <br /> To ID: 001 Merchant 10: 1251 <br /> I.. oat <br /> Phone Order ,e.. T <br /> Phone Order <br /> UOMOCall385Nq Sc 19681 <br /> VISA Entry Method: Martial VISA Entry Method: Manual <br /> Total: $ 100.00 <br /> Total: $ 100.00 <br /> 10f21,19 13:49:09 13:51:15 <br /> lnl•is 1 r ,i, poor Code: 032326 1�Mg fww Code: 641:15 <br /> CW2kirC: Online Batcht 29431 pd: Online Batcht 4:'1 <br /> Rob Code:lief M C4)2�: MICR M <br /> Ret�c.wl N.f.a: 541Bw8s <br /> Writes! Ref.x: 2U1UU004 <br /> I agree to Par . 3W total mount <br /> according to cad issuer aree.ent I area to Par ebwe total await <br /> Oter hent agreement if credit vovcherl accordlno to crd Issaa.. .rreaent <br /> /� Merchant areeaent if credit voucher) <br />