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

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

TYPE: Purchase

ACCT: Visa                  $ 140.77 USD

CARDHOLDER NAME : Lizbeth M Valle
CARD NUMBER     : ############3875
DATE/TIME       : 27 Jul 21 22:37:54
REFERENCE #     : 003 0950831 M
AUTHOR. #       : 043722
TRANS. REF.     : GV-1627439874

    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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