#_________ Name _____________________________________________________________ Store # __________
Date ______________________________ Parent Signature _________________________________________
Item			Item
Price			Price
Sales Tax Rate			Sales Tax Rate
Sales Tax			Sales Tax
Total			Total
Item			Item
Price			Price
Sales Tax Rate			Sales Tax Rate
Sales Tax			Sales Tax
Total			Total
Item			Item
Price			Price
Sales Tax Rate			Sales Tax Rate
Sales Tax			Sales Tax
Total			Total