SP CANCEL DT 01/01/01 03/28/19 01/01/01 01/01/01 01/01/01 01/01/01 1.0 FOR P6D CD 00 09 00 00 9895 9999 SS# 1307 ANNIV: 02/84 9895 EXPIR DATE: 2635 9999 NACH EFF DT: ADDR EFF DT: #SUPPS/CANC: EMAIL RETND: EMAIL [email protected] NAME CECILE DE JONGH JEANNE BRE WIEBRACHT

MERCHANDISE TOTAL 577.50 GIFT OPTIONS 50.00 SUBTOTAL $77.50 SHIPPING OFFER ($0.00) SHIPPING 84 HANDLING $25.00 TAX 50.00 TOTAL 5102.50 EXPIR. BILLING NAME AMOUNT 07/04/2016 Paypal $102.50 For additional order details, please click here to go to your account. For questions or comment

S $0.00 SUBTOTAL $220.50 SHIPPING OFFER ($0.00) SHIPPING 8 HANDLING $25.00 TAX $0.00 TOTAL $245.50 PAYMENT HISTORY DATE METHOD NUMBER EXPIR. BIWNG NAME AMOUNT 07/10/2016 Credit Card American Express - xxxxxxxxxxx1038 xx/xx Karyna Shuliak $245.50 For additional order details, plea

knums_displayed=l&TypeOfInquiryNumber=T&InquiryNumberl= 1Z18198R0305232593> EFTA_R1_01192512 EFTA02309664 PAYMENT HISTORY DATE METHOD NUMBER EXPIR. BILLING NAME ACTION AMOUNT 06/13/2012 Credit Card American Express - xxxxxxxxxxx10O0 xx/xx complete $272.19 Billing *If you ordered a J.Cre

knums_displayed=l&TypeOfInquiryNumber=T&InquiryNumberl= 1218198R0305232262> EFTA_R1_01192607 EFTA02309707 PAYMENT HISTORY DATE METHOD NUMBER EXPIR. BILLING NAME ACTION AMOUNT 06/13/2012 Credit Card American Express - xxxxxxxxxxx1000 xx/xx complete $272.19 Billing *If you ordered a J.Cre

py of this application must be carried in the, aft. 1QQ, !MI MRAD e*MT:57* "' AC Form 8050-1 (12/90) (0052-00-628-9007) Supersedes Previous PEG TO EXPIR-c: -i7 -66 T 00`4,5-4 EFTA00277999 FILED WITII FAA '00 NOU 16 TM 2 35_ - LAHcii-lik CITY OKLAHOMA • • EFTA00278000 UNITED STATES OF AM