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 21374

Pay Invoice

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

To: Zachary Ewer
120 East LaSalle St
Crystal, 48818

Date: February 9, 2021

Invoice Number: 21374

Invoice Due: February 28, 2021

Invoice Total: $143.66

Balance: $143.66

Task

Rate

Qty

%

Amount

Direct Premium Billing January

$139.48

1

-3%

$143.66

Notes

Thank you; we really appreciate your business.

Status Update
February 9, 2021 @ 7:47 pm

Status changed: Draft to Pending.