Receipt

Order ID: INT141024-4440-65352B
Order Created: 24 October 2014
Paid In Full: 10 November 2014

Purchaser

Maureen Cooper
EPM
Education Personnel Management Ltd
St Johns House Spitfire Close
Huntingdon, PE29 6EP
United Kingdom

Product Support
https://www.jotform.com
support@jotform.com

Seller

FastSpring
801 Garden Street
Suite 201
Santa Barbara, CA 93101
US

questionacharge.com
VAT Number: 375-3691-65

Description Quantity VAT Amount
JotForm Premium Monthly
Billed monthly. Next Billing Date On 11/23/14
1 US$1.99 US$9.95
Subtotal US$9.95
VAT (20%) US$1.99
Total US$11.94