<?xml version="1.0" encoding="UTF-8"?>
 <transaction xmlns:xfa="http://www.xfa.org/schema/xfa-data/1.0/">
  <receiptSerial>200312346</receiptSerial>
  <issuedAt>Ville</issuedAt>
  <issueDate>2003-02-10</issueDate>
  <taxYear>2003</taxYear>
  <donationAmount>567.34</donationAmount>
  <receiptAddr1>Tout nom de donateur</receiptAddr1>
  <receiptAddr2>456, du Boulevard</receiptAddr2>
  <receiptAddr3>Une ville, Une province, Un code postal</receiptAddr3>
  <signature xfa:contentType="image/tif" href="..\Images\Signature.tif"></signature>
  <receipt>
   <copyLabel>Foundation's Copy / Copie de la fondation</copyLabel>
  </receipt>
  <receipt>
   <copyLabel>Chapter's Copy / Copie de l'Émetteur</copyLabel>
  </receipt>
  <receipt>
   <copyLabel>Official receipt for income tax purposes / Reçu officiel pour fins d'impôt</copyLabel>
  </receipt>
</transaction>
