"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.

Credit card number 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
Bernice Stevens
31822 State Hwy 27
Guys Mills, 16327
Date
June 15, 2020
Invoice Number
10321
Invoice Due
June 30, 2020
Invoice Total
$806.18
Balance
$806.18
  1. Tasks
    Rate
    Qty
    %
    Amount

    Direct Premium Billing May

    $782.70
    1
    -3%
    $806.18
Subtotal $806.18
Total $806.18
Balance $806.18

Notes

Thank you; we really appreciate your business.