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Business Name
123 Main Street
City, State 12345
(555) 123-4567
Trans:14005
Register:1
Store:4068
QtyItemAmount
1Item 1$29.99
2Item 2$15.00
Subtotal$59.99
Tax$5.40
TOTAL$65.39
12/21/2025, 02:13:56 PM
Card number**** **** **** 4922
Card typeDebit
Card entryChip
Date/time11/20/2019 11:09 AM
Reference #62845289260246240685C
StatusAPPROVED
Thank you for your purchase! Returns accepted within 30 days with receipt.