Billing

First Name *

Last Name *

Street Address *

Street Address 2

City *

ZIP Code *

State *

Country *

Credit Card

Cardholder Name *

Card Number *

Expiration Date *

Expiration Date *

Security Code *

Invoice 481823

Pay Invoice

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

To: William Kuda
PO Box 103 PO Box 103
Martinsburg, 65264

Date: November 2, 2023

Invoice Number: 481823

Invoice Due: November 30, 2023

Invoice Total: $128.96

Balance: $128.96

Task

Rate

Qty

%

Amount

Direct Premium Billing for October 2023

$125.20

1

-3%

$128.96

Notes

Thank you; we really appreciate your business.

Status Update
November 2, 2023 @ 6:16 pm

Status changed: Draft to Pending.