ABN: 33380054835

Tax Invoice/Receipt

Receipt number 200024237112 Date 19.12.2019

KURNIAWATI,NI Komang
ImmiAccount Name BP no: 1020088396 Email: Komangkurnia80@gmail.com

Total Due 146.91 AUD

Payment Received 146.91 AUD

Balance Due 0.00 AUD

Product and Description Qty Amount (AUD)

Details
Reference No: EGOOQ1INTM
Main Applicant: NI Komang Kurniawati ( 05.04.1979 )
6101 FA600 Visitor/Tourist outside Australia 1 145.00
Sub total for FTRN 9016356087 145.00
Credit Card/PayPal Surcharge 1.91

Total Due (AUD) 146.91

Payment Details
Card Holder Name:Isabel McHutchison
Card Payment VC - 455701*******606 ( 200024237112 ) 146.91
Response : 0 - Approved AuthCode : 935301238993
Order ID : 2071741470 Merch ID : DICCOM03

Payment total (AUD) 146.91

ORIGINAL RECEIPT
Comments

* GST applies to this item and is equal to 1/11th of the total charged for this item. If a credit card surcharge applies then the GST component of the
surcharge is also 1/11th.