| Item | Desc. | Qty | Unit Price | Subtotal | Discount | Subtotal After Discount |
| Total Before Discount: | $ | |||||
| Total After Discount: | $ | |||||
| Shipping Fee: | $ 12 | |||||
| Sales Tax: | $ 0 | |||||
| Grand Total: | $ 12 | |||||
| Reference Number | 572 |
| Payment Method | Credit card payment |
| Is partial shipment ok if item is back ordered? | Yes |
| Shipping Address: | |
| First Name | Diana |
| Last Name | Paredes |
| Phone Number | (715)8911920 |
| Other Contact Number | |
| School Name | |
| Address | 5923 STATE Highway 70 W |
| City | Eagle river |
| State | WI |
| ZIP Code | 54521 |
| Country | United States |
| Comments | |