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

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

TYPE: Purchase

ACCT: Visa                  $ 962.80 USD

CARDHOLDER NAME : Jennifer R Allen
CARD NUMBER     : ############2110
DATE/TIME       : 02 Jun 21 13:30:48
REFERENCE #     : 003 0532726 M
AUTHOR. #       : 049528
TRANS. REF.     : GV-1622655048

    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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