Review & Payment Information

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review all information below. Upon successfully submitting this order an email confirmation will be sent to the billing email address provided.

Order Information

Billing Address

Sergio r i Ortiz rti anguiano i

1048 W. Stone Creek Cir.

Crystal Lake IL 60014

United States

Phone: 847-***-****

Email: ad3ntf@r.postjobfree.com

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Shipping Address

Sergio r i Ortiz rti

anguiano i

1048 W Stone

Creek Cir

Crystal Lake IL

60014-1937

United States

Phone: 847-***-****

Email: ad3ntf@r.postjobfree.com

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Order Detail

Description Quantity Unit Price Unit Total

Blue l Energy r

Blend l (30 pack

box)

1 $69.00 $69.00

Sub Total: $69.00

Shipping & Handling: $10.18

Sales Tax: $0.60

Order r r Total t l ($USD): : $79.. 78

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Payment Information

Payment t Method t

Visa Card

Name on Credit r it Card r

Sergio Ortiz

Credit r it Card r Number r

Credit r it Card r Expiration ir ti Date t

November - 11

2027

Card r Security rit Code

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