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111 (2_0 <br /> CITY if MME O05 CITY OF Watt POS CITY CF Wear P05 <br /> MO 11 10111 AVE STE 4W 100 R 10TH AVE STE 400 108 u 18TH AVE STE 400 <br /> IllGRE• OR 97401 EUGENE. OR 97401 1 EtGEHE. 0R 97401 <br /> (541) 682-9077 (541) 6824677 (541)682-5677 <br /> 01,u920 23°�d0 REPRINT I REPRINT <br /> IRS REPORT Bark ID: 1388 Bank ID: 1381 <br /> Merchant ID: 1251 I Merchant ID: 1251 <br /> WO Term 1D: 001 Ter.ID: 001 <br /> ,.tel Phone Order Phone Order <br /> Card fnl Sale yyyyyyVyyyyy p� <br /> vS 3 187.45 187.45 �� AN'Nu1A40A1A1841 <br /> „6 1 10090 lee.00 Entry Method: Ma<Eal M4$iERC Entry Method: Itamal <br /> Sale Total: 4 287.45 <br /> Total: 287.45 Total: $ 37.45 Total: $ 100.00 <br /> 614920 1319:3 814340 14:11:59 <br /> Inv ft: ';;:;+ tar Code: ,:;7 Inv M: sss;sc Ayr Code: ii39541 <br /> land: Online Eats' ;;:; 1 Aoal►d: Online Batchd: s,.I 1 <br /> Ene of EOCENE C142 Cock: MpICM N CPV2 Cade: 114ICH M <br /> 3130 u UIE. AVE STE 4130 Retrieval Ref.N: 1123/3139 Retrieval Ref.N: 21229147 <br /> EUGENE. OR Y7401 <br /> (5411 682-5677 <br /> I agree to oar above total agwnt 1 a+'•e to oar above total amount <br /> Ter. ID: OW according to card lower occ^'�,re to card littler areeaent <br /> /Merchant aw'eement if agreement IMr,h.M agreement if credit voucher; <br /> (:::09.4—..") <br /> 23:02:15 credit voucher; <br /> SEiiIfIEMi REVCRI p �z ��Q^ r - rS e� ( , <br /> Batch W.: 9081 • -• ~1 <br /> Vogt Nr: URTV <br /> Ner chant: 1 <br /> Salsa 4 $ 287.45 CI IY La LUWE POS <br /> CI IY OF Milt POS 180 N 18TH AVE STE 400 <br /> Total : 4 8 7' 100 u 18H1 ATE STE 400 EUGENE. CO 97401 <br /> (- Successful EUGENE. OR 97481 1541) 6825677 <br /> Settleeent „�Itlrnful 1541) 6825677 1 <br /> REPRINT REPRINT <br /> Bank ID: 1363 <br /> 1:3630 + A lb: 383 <br /> Merchant 10: 1251 Tar.ID: 1251 <br /> 001,• : -- Term ED: 001 <br /> 1:0.00 + Sale Phone Order <br /> CGS 6:.c0 + 100030 000OCON <br /> Entry Method: Marcel <br /> 002•< .-•<� V VISN <br /> 16"•n3 VISA Entry Method: thio <br /> Total: $ 90.00 Total: $ 60.00 <br /> 37.45 + <br /> .. 11141/20 914923 13:6;59 <br /> 1300 - - 37> I ;r:' Haar Code: 60317Ips; Online Aaa�CCode, 81Ti� <br /> t orvd: Online Batcha: !" <br /> 130 <br /> Retrieval Ref.11: 51229141 CR Code: MTOH M <br /> 93•00 + Retrieval RSA: 2/229139 <br /> ;19: <br /> ' I awee to nay above total amount <br /> accnt a to card loweravrea.ent I agree to oar above total amount <br /> 9:.;.0 IMerchanthahent x'etaent lF credit vsucirer) accordingtocard issuer awreesant <br /> I tlbrdnnt awee.ent if credit vouccher)0• * K 14.er 5� ?3 .20 X ' , - 51/; <br /> MCOOMlt0&EI181GRIE `- '•� n <br /> At /D✓ � <br /> 16C•30 + VIS AwNNANr310113 Y <br /> + ISI: MO tkrchant 37.45 MR: 800000Mb Conit <br /> 911. 3 + <br /> 003 <br /> 287.45 * ENCRYPTED IRNISRCII0M f <br /> IRAH5ACf1016' <br />