30/01/2011

pH Miracle LivingReceipt

pH Miracle Living Receipt

*** PLEASE PRINT RECEIPT OUT AND RETAIN IT FOR FUTURE REFERENCE ***

Order 120462 Number

Customer ID Order Date 116095 1/30/2011 3:10:45 PM

Bill To: Rafael Mateo Suprema Qualitas C/Pedro a Bobea #2, Bella Vista Santo Domingo, -- 1809 Dominican Republic 8093507216 rafael_josem@yahoo.com Order Date: Payment Method: Card Type: SKU: 1/30/2011 3:10:45 PM CREDITCARD MasterCard Product

Ship To: SUPREMA QUALITAS DO80Q14212N 7801 NW 37 Street Miami, FL 33166-6503 United States 3055920839

Locale/Currency: en-US / USD Name On Card: Card Number: Rafael Mateo ****4582 Price $29.95 Ext. Price $89.85

Quantity 3

25.Supple.pHour.Salts pHour Salts

Order Notes: None

SubTotal: Shipping: Tax: Total: UPS Ground

$89.85 $11.49 $0.00 $101.34

phmiracleliving.com/receipt.aspx?order

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