"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.

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
Joe Velishek
39244 Co Rd 153
Deer River, 56636
Date
April 7, 2022
Invoice Number
301255
Invoice Due
April 30, 2022
Invoice Total
$115.15
Balance
$115.15
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing March

    $111.80
    1
    -3%
    $115.15
Subtotal $115.15
Total $115.15
Balance $115.15

Notes

Thank you; we really appreciate your business.

Status Update
April 7, 2022 @ 8:24 pm

Status changed: Draft to Pending.