Billing

First Name *

Last Name *

Street Address *

Street Address 2

City *

ZIP Code *

State *

Country *

Credit Card

Cardholder Name *

Card Number *

Expiration Date *

Expiration Date *

Security Code *

Invoice 540141

Pay Invoice

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

To: William Kuda
PO Box 103 PO Box 103
Martinsburg, 65264

Date: May 7, 2024

Invoice Number: 540141

Invoice Due: May 31, 2024

Invoice Total: $267.31

Balance: $267.31

Task

Rate

Qty

%

Amount

Direct Premium Billing for April 2024

$259.52

1

-3%

$267.31

Notes

Thank you; we really appreciate your business.

Status Update
May 7, 2024 @ 5:51 pm

Status changed: Draft to Pending.