"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
*
*
*
*
*
*
*
Credit Card
*
*
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*
From
The Advantage Group Advantage Group
43471 Ridge Park Drive, Suite B
Temecula, CA 92590
US
To
Travis Raddatz
31284 275th St
Redwood Falls, 56283
Date
February 18, 2020
Invoice Number
6559
Invoice Due
February 29, 2020
Invoice Total
$53.21
Balance
$53.21
  1. Task
    Rate
    Qty
    %
    Amount

    Direct Premium Billing January

    $51.66
    1
    -3%
    $53.21
Subtotal $53.21
Total $53.21
Balance $53.21

Notes

Thank you; we really appreciate your business.

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