"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
Aaron Bredvik
1415 n maple
Watertown, 57201
Date
July 17, 2020
Invoice Number
11667
Invoice Due
July 31, 2020
Invoice Total
$328.00
Balance
$328.00
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing June

    $318.45
    1
    -3%
    $328
Subtotal $328.00
Total $328.00

Notes

Thank you; we really appreciate your business.