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

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

TYPE: Purchase

ACCT: Visa                  $ 148.16 USD

CARDHOLDER NAME : Sandra Hooper
CARD NUMBER     : ############0126
DATE/TIME       : 12 May 21 15:26:21
REFERENCE #     : 003 0521158 M
AUTHOR. #       : 086522
TRANS. REF.     : GD-1620847581

    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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