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 2628

Pay Invoice

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

To: Justin Rhoades
203 Brian Ave
Murphysboro, 62966

Date: January 2, 2018

Invoice Number: 2628

Invoice Due: January 31, 2018

Invoice Total: $105.31

Balance: $105.31

Task

Rate

Qty

%

Amount

DIRECT PREMIUM BILLING

$102.24

1

-3%

$105.31

Notes

Thank you; we really appreciate your business.