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 4129

Pay Invoice

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

To: Trisha Frederick
1745 East Carleton road
Adrian, 49221

Date: September 5, 2018

Invoice Number: 4129

Invoice Due: September 5, 2018

Invoice Total: $2.72

Balance: $2.72

Task

Rate

Qty

%

Amount

Direct Premium Billing July

$2.64

1

-3%

$2.72

Notes

Thank you; we really appreciate your business.