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

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

TYPE: Purchase

ACCT: Visa                   $ 49.04 USD

CARDHOLDER NAME : Elizabeth Montgomery Nielsen
CARD NUMBER     : ############8695
DATE/TIME       : 09 Mar 21 20:21:55
REFERENCE #     : 003 0243985 M
AUTHOR. #       : 062120
TRANS. REF.     : GV-1615339315

    Approved - Thank You 100


Please retain this copy for your records.

Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
========================================