5.000 Ref: M D NELI 1 LANDIN FEE 3000 17.700 1 RAMP P RKING 3204 44.000 Subt tal: 126.700 7.0 ALES TAX 3.080 Total: 129.78 Auth 145803 AMERICAN EXP 129.78 4444 ******50i4 Customer Signature I agree amount e obligati terms of agreemen o the credit card own and to perform the ns set fort