EFTA01110208.pdf

LSJ, LLC 6100 Red Hook Quarters Suite B-3 St. Thomas, VI 00802-1348 Tel: Fax: 340-775-8108 E-mail: Wire Transfer Request Form Date of Request: 12/06/11 Amount Requested: $2,500.00 Payee: Suc. J. Serralles Second, Inc PO Box 801201 Payee Coto Laurel Address: PR 00780-1201 Bank Name: Bank of America 100 West 33rd St Bank New York Address: Bank Account: NY 10001 Requested Br tfI asen L. Gordon Purpose / Description: Quickbooks Memo: Purchase 10 Coconut Palms Special Notes / Instructions: G / L Account Information: G / L Description: Landscaping G / L Number: 601SSf Authorization EFTA01110208  SUC. J. SERRALLES SECOND. INC. ROBOX 801201 NumOrr 12-CCS•2011 COTO LAUREL. PR 00780-1201 Page: USA Date: 1'2,S:2011 Tel (787) 260-2221 I Fax (787) 260-2227 Sold LSJ L Ship To: To: 6100 RED HOOK QUARTERS B-3 GICO RED HOOK QUARTERS B3 ST. THOMAS 00802 ST THOMAS 00602 USVI Roforonco • ... No. Customer No. Salosporson Ship Via Terms Code ST THOMAS 1,.11-157 UPON Item No. Description/Comments Quantity UOM Unit Price Amount 01.11-15 COCONUT PALM 12O v., .) PIES 250 000000 2.50000 PRODUCT OF PUERTO RICO Due Date Amount Duo Disc. Date Disc. Amount 12/1512011 2 500 00 0 0: Remit To: Subtotal before taxes 2.500 00 SUC J SERRALLES SECOND. INC Total taxes 000 P 0 BOX 801201 Total amount 2,50000 COTO LAUREL. PR 00780.1201 Payment received 000 USA Discount taken 0 00 Amount due 2.500 00 Invoke EFTA01110209