11
4
CPC Chip Purchase Transaction – Signature Required
MERCHANT COPY
XYZ MERCHANT
890 PARK ST
MELBOURNE 3000
TERMINAL ID
00013009803
VISA CR
0010
PUR
AUD $20.00
TRANSACTION CURRENCY
USD
EXCH. RATE
0.7792
TOTAL USD 15.59
---------------------------------------------
SIGNATURE
VISA CREDIT
AID A0000000031010
APSN 01
C08006 ATC 0002
APPROVED
AUTH: 408196
STAN: 005199
28/02/12 15:27
I HAVE BEEN OFFERED A
CHOICE OF CURRENCIES FOR
PAYMENT, INCLUDING THE
MERCHANT'S LOCAL CURRENCY.
I ACKNOWLEDGE THE CURRENCY
CONVERSION SERVICE IS
CONDUCTED BY ANZ.
EXCH. RATE MARK UP 2.5%
COMMISSION/FEE $0.00
[ ] I AGREE TO THE
INFORMATION ABOVE
CUSTOMER COPY
XYZ MERCHANT
890 PARK ST
MELBOURNE 3000
TERMINAL ID
00013009803
VISA CR
0010
PUR
AUD $20.00
TRANSACTION CURRENCY
USD
EXCH. RATE
0.7792
TOTAL USD 15.59
VISA CREDIT
AID A0000000031010
APSN 01
C08006 ATC 0002
APPROVED
AUTH: 408196
STAN: 005199
28/02/12 15:27
MESSAGE LINE 1
MESSAGE LINE 2
I HAVE BEEN OFFERED A
CHOICE OF CURRENCIES FOR
PAYMENT, INCLUDING THE
MERCHANT'S LOCAL CURRENCY.
I ACKNOWLEDGE THE CURRENCY
CONVERSION SERVICE IS
CONDUCTED BY ANZ.
EXCH. RATE MARK UP 2.5%
COMMISSION/FEE $0.00
[ ] I AGREE TO THE
INFORMATION ABOVE
PLEASE RETAIN FOR YOUR RECORD