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Apple Store, Fifth Avenue
767 Fifth Avenue
New York. NY 10153
212-336-1440
DCA License A1226523 & 1226517
December 13, 2011 11:57 AM
iPhone 45 Black 64GB AT&T (5 849.00)
Part Number: MD269LUA
Serial Number: C39GQSVSDTDK
IPAD 2 WI-Fl 16GB WHITE • 5 PACK•USA $ 499.00
Part Number: MC989LUA
Serial Number: DMPGGYS4DKPH
Return Date: Dec. 27, 2011
For Support, Visit: apple.com/support
iPad Smart Cover- Pink $ 39.00
Part Number: MD30BLUA
Return Date: Dec. 27, 2011
For Support, Visit: APPLECOWSUPPORT
Sub-Total (5 311.00)
Tax@8.875% (5 27.60)
Total (5338.60)
Amount Refunded Via AmEx (Al (5 338.60)
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