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California BBS
1625 N Market Blvd Ste S-200, Sacramento CA 95834
EIN 47-1217096 · Reg #PA-520101
Receipt
TX-2987E520
2026-04-13
Billed to
Ezra Rivers
c/o Healthy Young Minds Payroll
2400 Bryant St Ste 300, San Francisco CA 94110
Payment
VISA •••• 6800
Auth 520101
Captured 2026-04-13
SKUDescriptionQtyUnitAmount
FEEAnnual LCSW renewal1$447.97$447.97
Subtotal$447.97
Sales tax (8.875%)$39.76
Total charged$487.73
Thank you for your purchase. Items returnable within 30 days with original packaging. Questions? Email support@californiabbs.com.
Paid · 2026-04-13
Submitted via Pelica · reimbursement rmb_4 · LicensingPage 1 of 1
Sample receipt rendered by Pelica. No real transactions occurred.