Receipt

Order ID: INT150429-7116-18376
Order Created: April 29, 2015
Paid In Full: April 29, 2015

Purchaser

Sandra Zelada
OrganizaciĆ³n Adoptame
Itaipu 837
Luque, 999
Paraguay

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

Seller

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

questionacharge.com

Description Quantity Sales Tax Amount
JotForm Premium Yearly
Billed yearly. Next Billing Date On 4/28/16
1 $0.00 $90.00
Subtotal $90.00
Sales Tax (0%) $0.00
Total $90.00