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 151381

Pay Invoice

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

To: Dustin Simpson
5039 Laur Rd
North Branch, 48461

Date: September 9, 2021

Invoice Number: 151381

Invoice Due: September 30, 2021

Invoice Total: $110.97

Balance: $110.97

Task

Rate

Qty

%

Amount

Direct Premium Billing September

$107.74

1

-3%

$110.97

Notes

Thank you; we really appreciate your business.

Status Update
September 9, 2021 @ 4:31 pm

Status changed: Draft to Pending.