"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
Chad Vronko
211 s pine st
Sheridan, 48884
Date
April 7, 2022
Invoice Number
301259
Invoice Due
April 30, 2022
Invoice Total
$203.45
Balance
$203.45
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing March

    $197.52
    1
    -3%
    $203.45
Subtotal $203.45
Total $203.45
Balance $203.45

Notes

Thank you; we really appreciate your business.

Status Update
April 7, 2022 @ 8:25 pm

Status changed: Draft to Pending.