"First Name" field is required.

"Last Name" field is required.

"Street Address" field is required.

"City" field is required.

"ZIP Code" field is required.

"State" field is required.

"Country" field is required.

"Cardholder Name" field is required.

"Card Number" field is required.

"Expiration Date" field is required.

"Expiration Date" field is required.

"Security Code" field is required.

Billing
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Credit Card
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From
The Advantage Group
Advantage Group
43471 Ridge Park Drive, Suite B
Temecula, CA 92590
US
To
Joseph Warner
6001 Huntington Ave
Lincoln, 68503
Date
January 20, 2021
Invoice Number
20904
Invoice Due
January 31, 2021
Invoice Total
$31.73
Balance
$31.73
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing December

    $30.81
    1
    -3%
    $31.73
Subtotal $31.73
Total $31.73

Notes

Thank you; we really appreciate your business.

Status Update
January 20, 2021 @ 6:05 pm

Status changed: Draft to Pending.