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Online Payment # 100

Company Name: Legacy Wealth Management  | Invoice #: 47864  |  Email Address: [email protected]

Total Amount Authorized to Charge: 477.33

Store Card: No, I will complete the payment page for any future orders.

Name on the card: Jeffrey Funderburk

Credit Card Information:

Card:   4246315382115911

Month:   2      Year:   2026       CVV:   393

Card Billing Address:

372 Ridges Blvd
Grand Junction, Colorado 81507