EFTA00449381.pdf

From: CARosa Limo To: 212JE-Larry & Dave < k Lesley Groff < Subject: Fwd: CAROSA - Transaction Receipt for $75.00 Date: Tue, 11 Apr 2017 00:21:59 +0000 Inline-Images: 58EC I D7326CC21BC12D7BD87BDED8575403B5443-sig.png Thank You, Gabriel Roque CARosa, LLC Begin forwarded message: From: DoNotReply(iOilling-notification.com Date: April 10, 2017 at 8:16:18 PM EDT To: Subject: CAROSA-Transaction Receipt for $75.00 Merchant ID: 5836739 Term ID: 001 Sale - Approved Date: 04/10/17 Card Type: American Express Entry Method: Manual Card #: XXXXXXXXXXa Invoice #: Approval Code: Lane ID: Customer Ref: Time: 20:04:02 Time Zone: EDT 002181 182565 5807 4/8 415LM Same Day Cancel Item Qty Amount Total Amount Base Amount $75.00 Amount $75.00 I agree to pay the above total amount according to the card issuer agreement. (Merchant agreement if credit voucher) EFTA00449381 Cardholder Signature Map of purchase location Merchant Copy EFTA00449382