Third Wave
Acquisitons; Invoices; Records
Third Wave
200 Primary Drive
Serena Quadrant, NYP 001820
“Creating the perfect balance for your relationship…”
Date: 87 Year 2856
Authorized by:Founding Director Mitch Sjorn
Ship via:
Private Courier
Signature Required
As per your inquiry, we have sent you the necessary items to assist your acquisition of described requests. Please submit all information in a timely manner so can begin the espousal process. Thank you for your business and have a wonderful partnership. - MSShip to attn.:Chanse Jarsk
Josian Tone
Issued to:
Jarsk-Tone Partnership
Location: 98.13148548270623
Description
Price
Contract
10.000 ∂
Credit Application10.000 ∂
ONE TIME Membership Application120.000 ∂
Specialties’ Catalog50.000 ∂
Purchase Order? ∂
(Please Calculate Total on Bottom of Purchase Order)Private Email Address provided by Location@balance
20.000 ∂
Purchase order number must appear on all invoices and correspondence. Please sign and return second and third copies. All Catalogs must be return and you will be refunded upon return.
Signature: Sjorn Mitch
Date: 87 Y2856
Purchase Order
Date: August 7, 2014
Invoice # JTP001
JARSKY-TONE PARTNERSHIP
Location: 98.13148548270623
98jtp13148548270623@balance.tw
Vendor:
Third Wave
200 Primary Drive
Serena Quadrant, NYP 001820
Phone 00. 8549643471
Fax 00. 1743561354
Customer ID 98J131T485P54827S0623
Shipping Method
Shipping Terms
Delivery Date
Pick Up
Pick Up
IMMEDIATE ACQUISITION
Quantity
Item #
Description
element
Price
Line Total
1
GAFIQ1618
Genius Adolescent Female
0100081
99001101
250.000
250.000
100.000.000
1
RHL0034
Red hair - Long
001100
997899
15.000
20.000
500.000.000
1
GGHR099
Hazel Eyes - Round
889900
564347
10.000
5.000
50.000
1
CCBM1044
Carmel Complexion - BM
112244
123321
15.000
10.000
50.000
1
BS36D
Bust 36 D
448800
336699
20.000
18.0000
65.000
1
WHS0030
Waist/Hip - 30” Firm Physique
999999
555543
29.000
88.000
250.000
1
H65SE
Height 5.5’
456987
235711
7.000
9.000
65.000
1BCESD2E20
Breeding CapaQuadrant: Joia – Enhanced Sex-Drive
100100
999100
500.000
850.000
1.500.500
- Please send two copies of your invoice.
- Enter this order in accordance with the prices, terms, delivery method, and specifications listed above.
- Please notify us immediately if you are unable to ship as specified.
- Send all correspondence to: Sjorn Mitch
Third Wave
200 Primary Drive
Serena Quadrant, NYP 001820
Phone 00. 8549643471
Fax 00. 1743561354
ANC – empath/telepath
IMM000
PUR000
50.000.000
50.000.000
500.000.000
Subtotal615.930.500
Sales Tax500.000
Total616.430.500 ∂
“Creating the perfect balance for your relationship…”
Josian Tone
94 Y2856
Authorized by
Date
ONE-TIME Membership Application
FIRST Applicant Information
Name: Chanse Jarsky
Date of birth: Day 210 Year 2701
IDN: 21012359
Contact: 98JTP13148548270623@balance.tw
Home Coordinate: 98.13148548270623
Employment Information
JARSKY AERONAUTICS
Employer Coordinates: 98. 1314855483010433
How long? 150 years
Phone:98-46923548017
E-mail: ChanseJarsky@jtp98.ea
Fax:98-221764439733
Quadrant: Joia
Region Fidrac
Code: 131
Position: Owner
Salary
Annual income: 300 Z∂
SECOND Applicant Information
Name: Josian Tone
Date of birth: 180 Year 2715
IDN:180150545
Contact: 98JTP13148548270623@balance.tw
Home Coordinate: 98.13148548270623
SECOND Employment Information
TONE CORPORATION
Employer Coordinates: 98. 1314855483310400
How long? 135 years
Phone:98-323028252243
E-mail: JosianTone@jtp98.ea
Fax:98-323028252255
Quadrant: Joia
Region Fidrac
Code: 131
Position: OWNER
Salary
Annual income: 295 Z∂
Emergency Contact
Name of a relative not residing with you: Roan Pewer
Home Coordinate: 98.13148548270625
Contact: RPMD0625@ph.ea
Relationship: Cousin
References
Name
Home Coordinate
Contact
Doctor Roan Pewer
98.13148548270625
RPMD0625@ph98.ea
Thea K. Traper
98.13148548270627
TraperFashions@tfi98.ea
Signatures
I authorize the verification of the information provided on this form as to my credit and employment. I have received a copy of this application.
Signature of FIRST:
Chanse Jarsky
Date:
94 Y2856
Signature of SECOND:
Josian Tone
Date:
94 Y2856
Dear Sirs,
Please Include Copies of all Tax Forms for FY2856 and FY2855. All information will be destroyed once transaction has been completed.Sincerely,
Sjorn Mitch
Founding Direction of Third Wave
Contoso, Ltd Credit Application for a Business Account
Business Contact Information
Title: CEO Josian Tone
Company name: TONE CORPORATION
Phone: 98-323028252243
Fax: 98-323028252255
E-mail: JosianTone@jtp98.ea
Employer Coordinates: 98. 1314855483310400
Quadrant: Joia
Region Fidrac
Code: 131
Date business commenced: 95 Y2678
Sole proprietorship: Yes
Partnership:
Corporation:
Other:
Business and Credit Information
Employer Coordinates: 98. 1314855483310400
Quadrant: Joia
Region Fidrac
Code: 131
How long at current address? 135 years
Phone: 98-323028252243
Fax: 98-323028252255
E-mail: JosianTone@jtp98.ea
Bank name: HUB Institute
Bank Coordinate: 98.3233048453341
Phone: 98-8712654930
Quadrant: Joia
Region Fidrac
Code: 131
Type of account
Account number
Savings
I8181981J
Checking
2678TC9500****
Other
G1982D1509L
Business/trade references
Company name: IN CAFÉ NATION
Employer Coordinates: 98. 1314855483310399
Quadrant: Joia
Region Fidrac
Code: 131
Phone: 98-2233462833
Fax:98-2233462834
E-mail: INCAFENATION@CAFENOW98.EA
Type of account: Supplier
Company name: AGENT RIDE
Employer Coordinates: 98. 1314855484410500
Quadrant: Joia
Region Fidrac
Code: 131
Phone: 09-2007266363
Fax:09-2007266364
E-mail: AGENTLY@ride0798.ea
Type of account: Transportation
Business Contact Information
Title: CEO/OWNER Chanse Jarsky
Company name: JARSKY AERONAUTICS
Phone: 98-46923548017
Fax: 98-221764439733
E-mail: ChanseJarsky@jtp98.ea
Employer Coordinates: 98. 1314855483010433
Quadrant: Joia
Region Fidrac
Code: 131
Date business commenced: 55 Y2656
Sole proprietorship: Yes
Partnership:
Corporation:
Other:
Business and Credit Information
Employer Coordinates: 98. 1314855483010433
Quadrant: Joia
Region Fidrac
Code: 131
How long at current address? 150 years
Phone: 98-46923548017
Fax: 98-221764439733
E-mail: ChanseJarsky@jtp98.ea
Bank name: HUB Institute
Bank Coordinate: 98.3233048453341
Phone: 98-8712654930
Quadrant: Hereon
Region Captiol
Code:000
Type of account
Account number
Savings
J031242H
Checking
265622JA18***
Other
J646B2776W
Business/trade references
Company name: EAMN Space Force
Address:98.00110001
Quadrant: Joia
Region Fidrac
Code: 131
Phone: 98-001100001
Fax: 98-001100002
E-mail:secretaryMN@EAMNSF98.gov.ea
Type of account: Private Contract
Company name: EA Planetary Flight
Address:98.45577274489
Quadrant: Joia
Region Fidrac
Code: 131
Phone:98.247752637
Fax:98.247752633
E-mail: ROGStand.eapf98.org.ea
Type of account: Consumer
Agreement
- All invoices are to be paid 30 days from the date of the invoice.
- Claims arising from invoices must be made within seven working days.
- By submitting this application, you authorize us to make inquiries into the banking and business/trade references that you have supplied.
Signatures
Title: Josian Tone
Date: 94 Y 2856
Title: Chanse Jarsky
Date: 94 Y 2856
For Value Received, I Sjorn Mitch hereby assign and transfer unto Chanse Jarsky and Josian Tone possession of Elysian Jocelyn Smith represented by the within Certificate, and do hereby irrevocably constitute and appoint the transfer the said Third on the records of the within named Corporation with full power of Attorney in the premises on day 100th Year 2866.
In presence of
Olena Bond Leale Toros
Legal Council Legal Council
Physical Examination
Name
Elysian Jocelyn Smith
Date
95 Year 2866
Allergies
Mushrooms, Insect Bites
DOB
100 Year 2850
Age
16
Height
65”
Weight
139 lbs
Blood pressure
120/60
Pulse
LMP
Problems Addressed
Medications
Rxs Written
Allergies
Auto injector of Epinephrine
Epipen
Insect Bites
Immunotherapy
Bendryl
Migraines
N/A
Risk factors reviewed
1.
Diet
2.Exercise
3.Safety (seat belts, smoke detectors, firearms, violence)
4.Smoking
5.Alcohol and other drugs
6.STDs/Contraception
7.Advanced directive
Disease prevention and recommendations
1.
Stroke and coronary disease (BP, cholesterol, weight, stress, aspirin - 81 mg./day)
2.Cancer (diet, vitamin C- 500 mg., E - 400 units)
3.Osteoporosis (exercise, calcium - 1500 mg., vitamin D - 400 units, estrogen)
4.Viruses and colds (wash hands, vitamin C – 500-1000 mg., Echinacea, fluids, zinc)
5.Other
Health maintenance (enter date, or P if done today, or WS for “will schedule”)
Immunizations
Td P
Flu P
Pneumovax P
Hep.B P
Hep.C P
Varicella P
Lab
CBC P
Chem P
TSH P
PSA P
Lipid profile P
U/A PHemoccults P
Other
Pap P
GC/CT P
Mammogram P
Bone density
Flex. sig. P
Treadmill P
Ophthalmology P
Other Recommendations/Referrals
Seek immediate help upon controlling empath/telepath and psychic abilities. Unable to medicate for migraines due to the patients inability to maintain control over additional sense. Perfect physical health though a bit underweight.
As per First and Second All other exams will be give by Family’s Physician Roan PewerdR fa kEREN
Date: 98y68
Last Revised: 190y67
HEALTH HISTORY QUESTIONNAIRE
All questions contained in this questionnaire are strictly confidential and will become part of your medical record.
Name Smith, Elysian Jocelyn
¨ M ¨ F (female last time I checked)DOB: 100y2850
Marital status:
¨ Single ¨ Partnered ¨ Married ¨ Separated ¨ Divorced ¨ Widowed (does concubined count)
Previous or referring doctor: F.A. Keren
Date of last physical exam: 189y2867
PERSONAL HEALTH HISTORY
Childhood illness:
¨ Measles ¨ Mumps ¨ Rubella ¨ Chickenpox ¨ Rheumatic Fever ¨ Polio
Immunizations and dates:
85y2866
¨ Tetanus
¨ Pneumonia¨ Hepatitis¨ Chickenpox¨ Influenza¨ MMR Measles, Mumps, Rubella
List any medical problems that other doctors have diagnosed
Patient was given dose of autoimmune therapy on 98y2867. Standard body scan to ensure internal systems are function at 100
Surgeries
Year
Reason
Hospital
55y2854
Tonsils’
Third Wave Sanctuary Medical Facility
01y2862
Appendix Eruption
Primary Emergency Medical Facility
Other hospitalizations
Year
Reason
Hospital
100y2863
Gifted Instability
Third Wave Sanctuary Medical Facility
66y2865
Psychic Shock
Third Wave Sanctuary Medical Facility
Have you ever had a blood transfusion?
No
Name the Drug
Strength
Frequency Taken
Allergies to medications
Name the Drug
Reaction You Had
HEALTH HABITS AND PERSONAL SAFETY
All questions contained in this questionnaire are optional and will be kept strictly confidential.don't Lie
Exercise
¨ Sedentary (No exercise)
¨ Mild exercise (i.e., climb stairs, walk 3 blocks, golf)
¨ Occasional vigorous exercise (i.e., work or recreation, less than 4x/week for 30 min.)
¨ Regular vigorous exercise (i.e., work or recreation 4x/week for 30 minutes)
Diet
Are you dieting?
No
If yes, are you on a physician prescribed medical diet?
No
# of meals you eat in an average day?
Rank salt intake
¨ Med
Rank fat intake
¨ Med
Caffeine
¨ Coffee
# of cups/cans per day? As many as I can get – Religiously
Alcohol
Do you drink alcohol? I would love to start.
If yes, what kind? Wine
How many drinks per week? As many as I can get away with.
Are you concerned about the amount you drink? Not yet
Have you considered stopping? Have to start first
Have you ever experienced blackouts? Does this count?
Are you prone to “binge” drinking? Not yet
Do you drive after drinking? Drive? I get to drive?
Tobacco
Do you use tobacco? Never, don’t want director’s yellow teeth
¨ Cigarettes – pks./day
¨ Chew - #/day
¨ Pipe - #/day
¨ Cigars - #/day
¨ # of years
¨ Or year quit
Drugs
Do you currently use recreational or street drugs?
I think you need them here.
Have you ever given yourself street drugs with a needle?
What's it like on the street? Never been outside.
Sex
Are you sexually active? Not yet
If yes, are you trying for a pregnancy?
ask one or two
If not trying for a pregnancy list contraceptive or barrier method used:
Any discomfort with intercourse? Don’t Know
Do you have frequent falls? Clumsy
Do you have vision or hearing loss? When convenient
Do you have an Advance Directive or Living Will?
Do I need one?
FAMILY HEALTH HISTORY
AgeSignificant Health Problems
AgeSignificant Health Problems
Father
Let me know if you find out, I’m curious
Children
Ask One or Two
¨ M
¨ F
Mother
Let me know if you find out, I’m curious
¨ M
¨ F
Sibling
¨ M
¨ F
¨ M
¨ F
¨ M
¨ F
¨ M
¨ F
¨ M
¨ F
Grandmother
Maternal
Need Parents to know that¨ M
¨ F
Grandfather
Maternal
Need Parents to know that¨ M
¨ F
Grandmother
Paternal
Need Parents to know that¨ M
¨ F
Grandfather
Paternal
Need Parents to know that
MENTAL HEALTH I am empathic/telepathic/psychic What do you think?
Is stress a major problem for you? Sometimes
¨
Yes
¨
No
Do you feel depressed?
¨
Yes
¨
No
Do you panic when stressed?
¨
Yes
¨
No
Do you have problems with eating or your appetite? I feel other people’s emotions.
¨
Yes
¨
No
Do you cry frequently?
¨
Yes
¨
No
Have you ever attempted suicide?
¨
Yes
¨
No
Have you ever seriously thought about hurting yourself?
¨
Yes
¨
No
Do you have trouble sleeping?
¨
Yes
¨
No
Have you ever been to a counselor? Doesn’t really help though need anchors.
¨
Yes
¨
No
WOMEN ONLY
Age at onset of menstruation: 13
Date of last menstruation: Now
Period every 21 days
Heavy periods, irregularity, spotting, pain, or discharge?
¨
Yes
¨
No
Number of pregnancies 0 Number of live births 0
Are you pregnant or breastfeeding?
¨
Yes
¨
No
Have you had a D&C, hysterectomy, or Cesarean?
¨
Yes
¨
No
Any urinary tract, bladder, or kidney infections within the last year?
¨
Yes
¨
No
Any blood in your urine?
¨
Yes
¨
No
Any problems with control of urination?
¨
Yes
¨
No
Any hot flashes or sweating at night?
¨
Yes
¨
No
Do you have menstrual tension, pain, bloating, irritability, or other symptoms at or around time of period?
¨
Yes
¨
No
Experienced any recent breast tenderness, lumps, or nipple discharge?
¨
Yes
¨
No
Date of last pap and rectal exam?
MEN ONLY What are the most common answers for the questions below? Please get back to me I’m curious
Do you usually get up to urinate during the night?
¨
Yes
¨
No
If yes, # of times _____
Do you feel pain or burning with urination?
¨
Yes
¨
No
Any blood in your urine?
¨
Yes
¨
No
Do you feel burning discharge from penis?
¨
Yes
¨
No
Has the force of your urination decreased?
¨
Yes
¨
No
Have you had any kidney, bladder, or prostate infections within the last 12 months?
¨
Yes
¨
No
Do you have any problems emptying your bladder completely?
¨
Yes
¨
No
Any difficulty with erection or ejaculation?
¨
Yes
¨
No
Any testicle pain or swelling?
¨
Yes
¨
No
Date of last prostate and rectal exam?
¨
Yes
¨
No
OTHER PROBLEMS
Check if you have, or have had, any symptoms in the following areas to a significant degree and briefly explain.
¨
Skin Ridiculously Sensitive
¨
Chest/Heart
¨
Recent changes in:
¨
Head/Neck
¨
Back
¨
Weight 139
¨
Ears
¨
Intestinal
¨
Energy level I’m awake.
¨
Nose
¨
Bladder
¨
Ability to sleep Still not Sleeping
¨
Throat
¨
Bowel
¨
Other pain/discomfort: Migraines
¨
Lungs
¨
Circulation
If you can figure out a way to get rid of my additional specialties I’d really appreciate it…the headaches are getting bothersome. Don’t know who my parents are so I don’t really understand what I am. I would really like to see a copy of your test results if possible.