Approved

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AVS Result:

CVV Result:

OK

Bleu Glove Concierge

474 Golf Court • Valley Stream, NY 11581

Personal Information

Full Name ^*

Address

Zip code

Phone Number

Email Address ^*

Transaction Details

$

Amount ^*

+ Convenience fee

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Description

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Bleu Glove Concierge

474 Golf Court
Valley Stream, NY 11581

Tell: (917) 334 - 4134

[response]

ID #[transid]

[created]

[cardholder]

$ [amount]

[cardtype]   [ccnum4]

Authorization Number

[authcode]

AVS Response

[avsresult]

CVV response

[cvcresult]

[otherTransaction]

Thank you for your payment.