| Nittany Beverage - 254 N Gill St (814) 245-5566 | ||
| 21 November 2008 - Order #416654 |
| John Doevherman | Order Total: | $120.62 | |
| 254 College Ave | Delivery: | $5.00 | |
| Collegian Apt # 746 | Tax: | $2.00 | |
| Tip: | $2.00 | ||
| 814-555-5555 | Total: | $150.00 | |
| Please leave with roomate, peter at front door. | Deposit: | $30.00 |
| I've read and agree to the terms and conditions pertaining to this order located at internet URL http://www.thirstyjoes.com/tc.html | |||
| S I G N A T U R E | 21 November 2008 | ||
| John Doevehermannh | |||
| This is an age restricted order requiring positive ID and proof of the recipient's age. By signing below you agree to abide by all state and local laws. | |||
| I understand furnishing alcohol to persons under 21 years of age is illegal and that is is my responsibility to verify the age of those drinking. | |||
| S I G N A T U R E | ID: | Driver Initials: | |
| F u l l N a m e f r o m I D | DOB: | (age 21 if DOB on or before 21 Nov 1987) | |
| Items Sold | Type | Volume | Quantity | Total |
| Miller Lite | 24 Bottles | 12 oz | 5 | $40.68 |
| Milwalke's Best | 30 Cans | 12 oz | 10 | $80.00 |
| Coca Cola Classic | 24 Bottles | 12 oz | 5 | $40.68 |
| Coke Zero | 30 Cans | 12 oz | 10 | $80.00 |