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

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

TYPE: Purchase

ACCT: Visa                  $ 156.28 USD

CARDHOLDER NAME : James M Williams
CARD NUMBER     : ############4722
DATE/TIME       : 29 Apr 21 20:19:11
REFERENCE #     : 003 0091631 M
AUTHOR. #       : 729500
TRANS. REF.     : GD-1619741951

    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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