Approved

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Amount:

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CVV Result:

OK

Ateres Eitz Chaim

Personal Information

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Address

Zip code

Phone Number

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Transaction Details

$

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Description

Repeated Payments

Ongoing 2 Months 3 Months 4 Months 5 Months 6 Months 8 Months 10 Months 12 Months 18 Months 24 Months 36 Months

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Ateres Eitz Chaim

358 Washington Ave
Cedarhurst, NY 11516

Tell:

[response]

ID #[transid]

[created]

[cardholder]

$ [amount]

[cardtype]   [ccnum4]

Authorization Number

[authcode]

AVS Response

[avsresult]

CVV response

[cvcresult]

[otherTransaction]

Thank you for your payment.