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  • Total: US$52.85 Items Not Eligible For Fsa/Hsa Total: US$0.00

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    PEDRO
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    This document is an order receipt from Zenni Optical for customer John Ayerdis of Humble, TX. The order includes two pairs of eyeglasses - a green frame with 1.50 standard index lenses for $29.95 and a brown frame with the same lenses for $17.95, with a $4.95 shipping charge. The total order amount is $52.85 to be paid by the credit card provided.

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    ZENNI FORM

    Original Title

    o 4826403440

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    This document is an order receipt from Zenni Optical for customer John Ayerdis of Humble, TX. The order includes two pairs of eyeglasses - a green frame with 1.50 standard index lenses for $29.95 and a brown frame with the same lenses for $17.95, with a $4.95 shipping charge. The total order amount is $52.85 to be paid by the credit card provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    21 views2 pages

    Total: US$52.85 Items Not Eligible For Fsa/Hsa Total: US$0.00

    Uploaded by

    PEDRO
    This document is an order receipt from Zenni Optical for customer John Ayerdis of Humble, TX. The order includes two pairs of eyeglasses - a green frame with 1.50 standard index lenses for $29.95 and a brown frame with the same lenses for $17.95, with a $4.95 shipping charge. The total order amount is $52.85 to be paid by the credit card provided.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 2

    ORDER DATE: 05/08/2023

    John Ayerdis
    ORDER NUMBER: #o4826403440
    2111 Cold River Dr
    Humble, TX 77396-4225

    US$52.85
    ORDER SUBTOTAL
    US$52.85
    TOTAL:
    US$0.00
    ITEMS NOT ELIGIBLE FOR FSA/HSA
    TOTAL:
    US$52.85
    ITEMS ELIGIBLE FOR FSA/HSA
    TOTAL:

    PAYMENT METHOD: **** **** **** 4552

    ITEMS ELIGIBLE FOR FSA/HSA


    Shipping: US$4.95
    Estimated Taxes: US$0.00

    Frame: 3222724 Color: Green US$29.95


    Lens: 1.50 Standard Index US$0.00
    Price: US$29.95
    Quantity: 1 Subtotal: US$29.95

    Frame: 3222715 Color: Brown US$17.95


    Lens: 1.50 Standard Index US$0.00
    Price: US$17.95
    Quantity: 1 Subtotal: US$17.95

    All amounts calculated in United States dollars.


    Thanks for choosing Zenni!
    Have a question? Give us a call at (800) 211-2105
    5:00AM - 9:00PM PST every day

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