Buyer Receipt

Receipt # 13955290
Receipt Date 7/23/2019
Received By Katerina M
Sold At Branch 638 - Hartford-South
Paid At:
999 - Corporate Sale Date 7/22/2019
Two Westbrook Corporate Center Suite 500
Westchester IL 60154 Buyer # 409799
(708) 492-7000 Buyer Name Societate A Comerciala "ESCON
CONSTRUCT" SRL
Branch Dealer # : Dealer
Branch Tax # : 2123572
Resale Certificate #
Registration Expires 6/3/2020

Sale License
StockNo Item # Year Make Model Color Mileage VIN Plate #
000-25519844 A-0078 2012 HONDA INSIGHT Gray 148,374 JHMZE2H36CS000319
Invoice To: Description Charges Payments Balance
Bid Amount $1,550.00
Societate A Comerciala "ESCON Buyer Fee $270.00
CONSTRUCT" SRL Service Fee $59.00
s. Alexandrovca Internet Fee $69.00
Sales Tax $98.42
Ialoveni, XX.

Check # / Reference No.

Wire Transfer - $2,046.42
20190723265152-ZZ

Total Payment $2,046.42

Amount: 7/23/2019 10:13:18 AM - Payment $2,046.42
Remaining Amount Due $0.00

PAID IN FULL Total $2,046.42 $2,046.42 $0.00

Special Notes:
This is a “routed export transaction” per 19 CFR 30.3, and by agreement Buyer is responsible for all export filing and licensing requirements.
ECCN: EAR99 Country Of Origin: JAPAN HTSUSA: 8703.90.0000 Tax ID: 352123607
Sold At (USPPI): 638 - Hartford-South 1462 Saybrook Rd, Middletown, CT , 06457. (860) 854-6761

Legend:For Mexican Customs Purposes Tax ID:352123607 A wholly-owned subsidiary affiliate of Insurance Auto Auctions,Inc.
Registrant#008-FEIN 95-3790111

Receipt Acknowledged by:

Print Name/Company/Title
Buyer Signature IAA Signature
<IAAI FFR 55308104 FREIGHTFORWARDC>
Seller Signature Date
IAA Doc: RP018.00 7/23/2019 10:16:04 AM Page 1 of 1