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E <br />• <br />E <br />6749401 <br />CITY OF SB SPECIAL EVE <br />731 S LAFAYETTE BLVD <br />SOUTH BEND, IN 46601 <br />01;2712025 <br />15:19:36 <br />CREDIT CARD <br />MC SALE <br />6749401 <br />�' ^ " XXXXXXXXXXXX6540 <br />1 <br />CITY OF SB SPECIAL EVE <br />22 <br />731 S LAFAYETTE BLVD <br />1 <br />SOUTH BEND, IN 46601 <br />0127'2C25 <br />I Code, <br />050305 <br />MID: XXXXXXXXXXXX401 TID: <br />15:19:36 <br />IOaXX371 <br />0wd: <br />Manual <br />Onlne <br />CREDIT CARD <br />unt: <br />$0.00 <br />MC SALE <br />le: <br />Card a XXXXXXXXXW6540 <br />Je: <br />M <br />SEQ V: <br />1 <br />Bath ;: <br />22 <br />SALE AMOUNT <br />$50.00 <br />CE <br />I <br />at Code: <br />050305 <br />ettad, <br />Manual <br />OnOie <br />CUSTOMER COPY <br />aunh. <br />$0.00 <br />.le. <br />le. <br />M <br />MOUNT $50,00 <br />I agee to pay above total amount <br />accordN to card issuer ageement. <br />(Merdunt ageement if Credit Voucher) <br />MERCHANT COPY <br />