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<br />FT, LAUDERDALE I PLANTATION, 710' S.W, ITtf STREET <br />PLANTATION, FL JUZ4 <br />TELEPHONE 1'14) ,.2-4500 Fax (1141 38Z-4110 <br /> <br />--'=:J <br /> <br />1031KXTD <br />07/19104U:16AM <br />07/23104 7:28AM <br /> <br />.... <br />Nblne lit. Addtl:u <br />GARRIN, HARMON <br />820 EOEN GREEN CT <br />ROSWELL. OA 30075 <br />US <br /> <br />",\111m <br />An'lnlDblu <br />()OJlllrtw'l> DalC <br /> <br />1/0 <br />$ 59.00 <br /> <br />Adult/Child <br />RODIII R.a\l: <br />RATE PLAN I.V1 <br />HHIl 425728136 GOLD <br />AL: OL #20161117147 <br />CAR: <br /> <br />CONFIRMA TION NUMBER: 83049991 <br /> <br />I~."', ..u~... ID ",pllcOllln -... ._........ Of olllor ..~... .."'. dO ",' ,...,.. any _...~ .,' <br />Ilv,),. 01 V~''''' "....11_ ih YOWl '0"'., ,. ..f..... d."".., frI. i. .val..... "" Vtu In 'I.. 1olIOY. <br />1 'OIOCllblll .", MlIIlllll, fe. I~"IIIII .. ,..I ..0","0 ..d ll/l10ll Iv ba I"''' pur....l1Id' d.bl. ~, IPII ....., <br />1t,III ....1_lICI pilI""'. "llIn,,,., ... ._.... loll. .. ,., I., ""' _ Of a.. ...I.....tIIIl Of I~.... <br />".0"'" , "0.... fOIIv."Nfl .10......' dOl...", al V,,, TOO"Y II '.lv.H. . ..edl. or i.eo lOIIIlN <br />.pplilocll/ll.Y .........,.' /II /I... "V"", 01." ......O.""i. /. ", ..,.IIM..' In lilY p."Y, ,.qvlta fjleclfl <br />.,..I/lOI""'_II"',cr._,....~lIlrllll.."JIy,-_tal"'./rf~.-,O <br /> <br />07123104 <br /> <br />2 <br /> <br />PAGE <br /> <br />"_",,,,,,___,,,_,,, _"'_''''' ",.."___ ..__,.' ..",__"..".... Sigtl"~'O <br /> <br /> <br />..:,:-f-..=~I-:~L~OOMO~:;CAlI:~~~----- ...-- ....- fDA:~_- <br /> <br />07120104 426881 TELEPHONE.LO (INTERSTATE) $0.20 <br />07/20104 426881 STATE COMMUNICATION TAX $002 <br />07120104 426881 LOCAL. COMMUNICATIONS TAX SO 01 <br />07l20J04 426903 GUEs'r ROOM $511,00 <br />01120104 426903 STATE TAX n,54 <br />07/20/04 42G903 CITY TAX 12.95 <br />07121104 427075 TELEPHONE-LOCAL $1.30 <br />07121/04 427115 TELEPHONE-I.P (INTF.RS"l'ATE) $1.30 <br />, 07/21/04 4Z114i STA~ ~~MiJ"CA'fiON TAX $0.12 <br /> <br />;to, ";"~;~~~: ~."":~~:: ~~~~~~~(~~~~;it} :.~ <br /> <br />07/21/04 427116 STATE C~MMUNICATION TAx'" $0.03 <br />07n1104 427116 dlfc"L4:,M}.1,Wflllqi''fJ.ON.~.~:'':iff :();'~ 'i{.i"'!; $0.02 <br />07121104 42711 a riLlp.~O"tIlB'.L\l.(ll'illfIRS'1l~~).i ,,,......,..,,.2.',. !, $0.50 <br />07121104 427118 STATE COMMUNICATION TAX ' , ',' . 10.05 <br />07121104 427118 LOCAL COMMUNICA liONS T~, ." 'i"I;;'~" $0.03 <br />07/21/04 427119 TELEPHONE-LO (INTE RST ATE.)' I/'!J ~H.I"'f '! ; :... SO<<l <br />Om1l04 427119 STATE COMMUNICATION TAX $0,04 <br />07/21104 427119 LOCAl. COMMUNICATIONS TAX $0 02 <br />07/21/04 427121 TELEPHONE.LOCAL $0,20 <br />07/21104 427122 TELEPHONE.LOCAl $050 <br />07/21104 427123 "ElEPHONE.LOCAl $0.50 <br /> <br />I <br /> <br />.___..,..,__..,___..____.1_ <br />ACOClU1H NO. <br /> <br />______.1}.., Jm~ ~ .. <br />I).HI! 0\' t~IIAR(j~ f ,J Jt:tll, NO, <br /> <br /> <br />..---....".--,...-' -'-. ---'-]-'.'-~ <br /> <br />..~\:~I=.~~_...___._- '~~:AL I <br /> <br />l"UU:IIA~i'~" SBIlVICIl5 l <br /> <br />."..--..,..--...,..-.....'.,,---..'-.... <br /> <br />..'~:P::M/f~-....__..,,:-.,,'--, <br />I <br /> <br />..".,-.,.-. ,.._.._,..._._--",.....~'-_._,"'_._-_. <br /> <br />--...,.,--..-,.,----....,..-"' ,,'.--..-.,........---........-...--..-..-'.-.....'..--....'.'.... <br /> <br />t,,~1l 1o(11MIlf.f<, N^MIl <br /> <br />Im:.\iiU;;;,;iitj~N~ocMi(;".i..,.,-;:;;;;~;~~:;;;;:~~:;;,;;.;:T~~-;.;;; '.~;;;';;;~~-;;;;;~;;';..,. <br /> <br />I <br />i <br /> <br />I <br />It_....~~"'~~~~~~~=~-.=~==-~=j <br /> <br />-~~I:~~~~::] <br /> <br />0.00 <br /> <br />"""""""''' A,.~"Ut "...,":11;; ..,.""".kh.W 'rlU' ,'..50" '.11"'-1. M''', "r....:'U.1U'1 Coli ,UHU.,,"l11'tlK" (j,,'U "':11'''', <br />rA '\'..Il'....,ltJlli"~N Rfl(":U"" . 1% l'Il.R ,.",,,,"'IlIN'rl,'.Ilt:lir 1:1."ItC;I: wu.&. UI. A./'I'UED TO .u.L I'AWI' UUEIN~OICf_~, <br /> <br /> <br />T <br /> <br />H <br /> <br />A <br /> <br />N <br /> <br />K <br /> <br />y <br /> <br />o <br /> <br />u <br />