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/ M 1®h 6L,re <br />-11~ rt C--N r 7/- <br />J <br />i rh c 7-^Q~aw,/ to C PLIe%r . a r <br />- fl4 <br />t, <br />y 431750146880 <br />CIT4 R;;o OF EUGENE <br />1t01 OAK ST. <br />E541-1 9-7433 1 <br />TERMINAL I.D.1 25014681 <br />MASTERCARD <br />SALEXXXXXXXX9973 <br />BATCH, 800144 I NU = 1, <br />DATE: HN NO: 063954 ' lA SG:II <br />CE <br />AVS: 101 97401 4 <br />TOTAL - $145.00 <br /> <br />N I AGREE TO PAY ABOVE IOTRL AMOUNT <br />ACCORDING TO CARD ISSUER AGREEMENT <br />(MERCHANT AGREEMENT IF CREDIT VOUCHER) <br />***CUSTOMER COPY*** <br />