EFTA00309959

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Recei t Confirmation #: Passenger Name: Date & Time Of Service: ec . Car Type: Camry WiFi / Similar Passengers/Luggage: 1 / 1 Pick Up: Extra Stops: Destination: TEB RP n212je Form of Payment: Amex ********"*3001 Exp: 08/16 Fare Breakdown: Base Fare: Toll: Gratuity: NYS-Fund Tax: 68.00 21.50 13.60 2.58 Account Requirements: Total Charge: 105.68 Dec 21, 2015 12:42 PM Page # 1 EFTA00309959

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