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Bill To Bristol Associates 1023 15th Street N.W. Suite 1100 Washington, DC 20005 USA Invoice D
7417 nvoice Date: 04/29/2011 Account 617185 Amount Due: $850.00 PAYABLE IN US FUNDS Pay by: K Check/Money Order K Discover o MasterCard 138 K Visa CI American Express Card Number Name on the card Expiration date Signature Please detach and return with payment rhit —rtittor EXIIITRE CONTRO
es below. K Referring Physician: MOSKOWITZ BRUCE W. M D. M.D. K Referring Physician's Address: 11 N
me Accession 10/14/20157:30 AM EDT MRLSPNI MOSKOWITZ, BRUCE W, M.D 6784742 PAYMENT IS DUE AT THE TIME OF SERVICE K Cash K Check K Mastercard K Visa K Amex K Discover I HEREBY ACKNOWLEDGE THAT I AM FULLY RESPONSIBLE FOR ANY UNPAID BALANCES. Signature of Patient or Guardian: £LLbh£LZLZ 643etal
06/05/2018 Referring Physician: MOSKOWITZ. BRUCE W. M.D. M.D. Acc# 7156124 IMPORTANT: Please notify
Accession 06/05/2018 8:30 AM EDT MRCLAVL MOSKOWITZ, BRUCE W, M.0 7156124 PAYMENT IS DUE AT THE TIME OF SERVICE 0 Cash 0 Check 0 Mastercard K Visa 0 Amex 0 Discover I HEREBY ACKNOWLEDGE THAT I AM FULLY RESPONSIBLE FOR ANY UNPAID BALANCES. Signature of Patient or Guardian: goon/noon WI xv O
Entities connected to both George W. Bush and K Visa

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Joe Biden
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Joi Ito
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Richard Kahn
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