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Title: Paid and ordered
Name/Blogspot nick:
Email address:
Account type and no.:
Item #1
Item name: Pi Be Rational
Colour: Asphalt
Size: small (mens)
Qty: one
Url: http://www.snorgtees.com/piberational-p-563.html?osCsid=457ac3bb9cabb8c7f7bbea93161a4f76
Alternative: (Same or lower value)
Price in USD: US$16.95
Item #2
Item name:
Item code:
Colour:
Size:
Qty:
Url:
Alternative:
Price in USD:
Total in USD:
Total in SGD: [(Price in USD after 10%
discount) x 1.53] + US$5.00 =
Paid via: ATM / IBanking
To account: POSB/UOB
Account no.:
Date & Time of transfer:
Reference No:
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