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

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

TYPE: Purchase

ACCT: Mastercard            $ 351.39 USD

CARDHOLDER NAME : DORA EMANUELLI
CARD NUMBER     : ############9963
DATE/TIME       : 01 Feb 21 18:20:30
REFERENCE #     : 003 0012384 M
AUTHOR. #       : 73569Z
TRANS. REF.     : GD-1612221630

    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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