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 4555

Pay Invoice

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

To: Bernice Stevens
31822 State Hwy 27
Guys Mills, 16327

Date: January 14, 2019

Invoice Number: 4555

Invoice Due: January 31, 2019

Invoice Total: $411.16

Balance: $411.16

Task

Rate

Qty

%

Amount

Direct Premium Billing December

$399.18

1

-3%

$411.16

Notes

Thank you; we really appreciate your business.