Billing

First Name *

Last Name *

Street Address *

City *

ZIP Code *

State *

Country *

Credit Card

Cardholder Name *

Card Number *

Expiration Date *

Expiration Date *

Security Code *

Invoice 265020

Pay Invoice

From: The Advantage Group
Advantage Group
43471 Ridge Park Drive, Suite B
Temecula, CA 92590
US

To: Steven Frost
114 double oak road
Warrior, AL 35180
US

Date: December 30, 2021

Invoice Number: 265020

Invoice Due: December 31, 2022

Invoice Total: $29.16

Balance: $29.16

Task

Rate

Qty

%

Amount

Direct Premium Billing November

$28.31

1

-3%

$29.16

Notes

Thank you; we really appreciate your business.

Status Update
December 30, 2021 @ 2:33 pm

Status changed: Draft to Pending.