EFTA01223655

LSJE, LLC 6100 Red Hook Quarters, Suite B-3, St. Thomas, VI 00802-1348 Phone:-E-mail: [email protected] Credit Card Request Form Date of Request: Payee: 11/06/18 Amount Requested: $1,939.66 island Marine Outfitters/RN Payee Address: Payee Contact: K Check box if GL coding is split Invoice NJMemo: Cust No 31190 GL Description: l As noted on each invoice l As noted on each invoice GL Code: GL Amount: Invoice NJMemo: I•••••••• GL Description: GL Code: GL Amount: GL Memo: K Check box if additional pages are included Other Notes/ Instructions: Date Approved: Approved by: GL Memo: 11/06/18 shala14- EFTA01223655