========== TRANSACTION RECORD ==========
GERMED LTD

NEW HYDE PARK, NY
United States
WWW.GERVETUSA.COM

TYPE: Purchase

ACCT: Visa                   $ 73.78 USD

CARDHOLDER NAME : Maggie Burgwin
CARD NUMBER     : ############1753
DATE/TIME       : 27 Aug 20 12:39:27
REFERENCE #     : 003 0345055 M
AUTHOR. #       : 081886
TRANS. REF.     : GV-1598546367

    Approved - Thank You 100


Please retain this copy for your records.

Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
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