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DocuSign Envelope ID:5A4E8565-A097-44D6-84D3-56FC2C787A9F <br /> Customer Receipt No. 1031923-100286-202358 Monday- 10/28/2019- 11:17.49 AM <br /> ORANGE COUNTY HILLSBOROUGH SELF STORAGE ANNEX <br /> ALAN DORMAN (ELIZABETH BRADY RD.), 1031923 <br /> 300 WEST TRYON ST 346A ELIZABETH BRADY RD. <br /> HILLSBOROUGIL NC 27278 HILLSBOROUGH,NC 27278 <br /> (919)619-8859 (919)644-6776 <br /> --------------------------------------------------------------------------------------------------------------------------------------------- <br /> ROOM DESCRIPTION THRU PAID AMOUNT <br /> K86 (1)- 1OX20X8 INTERIOR LOWER LEVEL STREET LEVEL CLIMATE ROLL-UP 11/27/2019 [X] $145.00 <br /> Sub Total• $145.00 <br /> Talc: $0.00 <br /> Charge Total: $145.00 <br /> ************2406 Visa Card $145.00 <br /> 090362 <br /> Payment Total: $145.00 <br /> Change Due: $0.00 <br /> Account Balance: 50.00 <br /> -------------------------------------------------------------------------------------------------------------- <br /> X X <br /> Customer's Signature Employee's Signature(Mark Smith-Main) <br />