From: [email protected] To: Subject: Your Signed Receipt - Marmur Medical Date: Fri, 27 Oct 2017 14:57:34 +0000 EFTA00569409

Marmur Medical Marmur Dermatology and Cardiology PLLC BILLED TO DETAILS DETAILS TYPE APPROVAL TRANS ID MID TID TERMINAL AID TVR IAD TSI ARC INVOICE Signature 10/27/17 74.101.166.117 Cardmember acknowledges receipt of goods and/or services in the amount of the total shown hereon and agrees to perform the obligations set forth by the cardmembees agreement with the issuer. 10/27/2017 10:56 AM EDT 1050 PARK AVE STE 1A NEW YORK. NY, 10028 212.996.6900 (Office) 646-376-5140 (Fax) Approved Charge - Capture 883447 15629 6078 74447847 182393 AO 00 00 00 25 01 08 01 0000008000 844FF044B1AB515D3030 E800 00 1509116167575 ACCOUNT AMERICAN 2086 EXPRESS— Entry Mode Chip CVM SIGN AMOUNT USD$820.00 TOTAL $820.00 Having trouble reading this in your email client? Click Here. by PayJunction gt, PayJunction EFTA00569410