Case File
efta-efta00521017DOJ Data Set 9OtherPage I of I
Date
Unknown
Source
DOJ Data Set 9
Reference
efta-efta00521017
Pages
1
Persons
0
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Page I of I
RECEIPT
DULLES GLASS AND MIRROR
9151 EUCLID AVENUE
Mannassas , VA 20110
Phone 703-361-9994
[email protected]
Transaction Type : Sale
Authorization Code : 202880
AVS Result : Y - Match. Street address and 5•dlgit postal code match.
Total : 4282.58 USD
Cardholder Information
Name
Credit Card Type : American Express
Credit Card Number: xq x*4*.: quad 2037
Level II Fields
Tax Exempt : NO
10/15/2012
hups://e6c.cybersource.com/ebc/virtualterminal/PrintSingleReceiptLoad.do
10/15/2012
EFTA00521017
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