"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.

"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.

Credit card number is required.

Billing
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Credit Card
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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
Michael Erickson
308 south foster st
Merrill, 54452
Date
April 22, 2021
Invoice Number
47687
Invoice Due
April 30, 2021
Invoice Total
$289.04
Balance
$289.04
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing March

    $280.62
    1
    -3%
    $289.04
Subtotal $289.04
Total $289.04

Notes

Thank you; we really appreciate your business.

Status Update
April 22, 2021 @ 5:19 pm

Status changed: Draft to Pending.