Receipt

Order ID: INT180225-2965-54697
Order Created: 2018. február 25.
Paid In Full: 2018. február 25.

Purchaser

Fitos Szilárd
C&I Hitelnet Kft.
Deák F. u. 65
Gencssapáti, 9721
Magyarország

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: EU372017645

Description Quantity VAT Amount
JotForm Bronze Yearly
Billed yearly. Next Billing Date On 2/24/19
1 51,30 USD 190,00 USD
JotForm Bronze Monthly
Billed monthly. Trial Until 3/24/18
1 5,13 USD 19,00 USD
Subtotal 209,00 USD
VAT (27%) 56,43 USD
Total 265,43 USD



Refunds and Returns
( Returned Amount / Returned Tax Amount )
február 25, 2018 14:42:44 Refund : 19,00 USD / 5,13 USD from JotForm Bronze Monthly -24,13 USD