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 11717

Pay Invoice

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

To: Josiah LeCrone
4721 joyner Rd
Elm City, 27822

Date: July 17, 2020

Invoice Number: 11717

Invoice Due: July 31, 2020

Invoice Total: $82.68

Balance: $82.68

Task

Rate

Qty

%

Amount

Direct Premium Billing June

$80.27

1

-3%

$82.68

Notes

Thank you; we really appreciate your business.