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 3674

Pay Invoice

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

To: Eric Porth
51898 County Road 310
Bigfork, 56628

Date: June 5, 2018

Invoice Number: 3674

Invoice Due: July 1, 2018

Invoice Total: $55.14

Balance: $55.14

Task

Rate

Qty

%

Amount

DIRECT PREMIUM BILLING

$53.53

1

-3%

$55.14

Notes

Thank you; we really appreciate your business.