LLC Formation Payment Receipt

2/9/26, 2:31 AM Common Checkout Payment Receipt # Tyler Payments Services ## Payment Receipt Confirmation Your payment was successfully processed. ## Transaction Summary | Description | Amount | |-------------|--------| | Total Payment To Division of Corporations | $125.00 | | Service Fee | $0.00 | | **Total Amount Paid** | **$125.00** | ## Transaction Detail | SKU | Description | Unit Price | Quantity | Amount | |-----|-------------|------------|----------|--------| | 200466935012 NEW | New Limited Liability Company | $125.00 | 1 | $125.00 | | | Service Fee | $0.00 | | $0.00 | | **Total Amount Paid** | | | | **$125.00** | ## Customer Information - **Customer Name:** Johan Jongsma - **Local Reference ID:** 200466935012 NEW - **Receipt Date:** 2/9/2026 - **Receipt Time:** 02:31:09 AM EST ## Payment Information - **Payment Type:** Credit Card - **Credit Card Type:** MAST - **Credit Card Number:** ******2208 - **Order ID:** 254968740 - **Name on Credit Card:** Johan Jongsma ## Billing Information - **Billing Address:** 851 Brightwaters Blvd NE - **Billing City, State:** Saint Petersburg, FL - **Billing Zip/Postal Code:** 33704 - **Country:** US --- Visit tylertech.com/mtd for license information and disclosures. NIC Services, LLC dba Tyler Payments Services • 7701 College Boulevard, Overland Park, KS 66210 • (888) 853-0663 NIC Payment Solutions in Hawaii, New Jersey & Wisconsin