INVOICE Non-Negotiable UPPERCASE FULL NAME™

INVOICE NUMBER # 01234

DATE: ENTER DATE
John: of the family Doe
Care of Your address
Your City/Town 1234
BILL TO:
Bent Banker in his private capacity
Bank Physical Address
ADDRESS 12345

FOR:
Charges under Un-rebutted Agreement via Tacit, sent Recorded Delivery Dated
< enter date >, Recorded Received < enter date > , for Breaking our Agreement

DESCRIPTION CHARGE RATE AMOUNT

1. NZ$ < enter amount > for invalid claim by ‘Statement $6,300 1x $6,300.00
Period < enter date period >' after failure to provide
verification of alleged liability, as per the agreed Fee
Schedule set out in our lawfully binding agreement dated
< enter date >, recorded received < enter date >.

2. NZ$ < enter amount > for invalid claim by ‘Statement $6,300 1x $6,300.00
Period < enter date period >' after failure to provide
verification of alleged liability, as per the agreed Fee
Schedule set out in our lawfully binding agreement dated
< enter date >, recorded received < enter date >.

3. NZ$1,000.00 for two hours of Authorized $1,000 2x $2,000.00

Representative’s time required, nunc pro tunc, as per the
agreed Fee Schedule set out in our lawfully binding
agreement dated < enter date >, recorded received <
enter date >.

4. NZ$1,000 for recorded mail, nunc pro tunc, as per the

$1,000 1x $1,000.00
agreed Fee Schedule set out in our lawfully binding
agreement dated < enter date >, recorded received <
enter date >.

========
$15,600.00

Make all cheques payable to UPPERCASE FULL NAME™

Total due in 7 days. Overdue accounts may incur further charges.

You may only use my legal entity name when sending payment.
Late payment Fee of $1,000.00 per day. Thank you for your business.

Authorised Representative, All Rights Reserved

No assured value, No liability. Errors & Omissions Excepted. All Rights Reserved.
WITHOUT PREJUDICE – WITHOUT RECOURSE – NON-ASSUMPSIT
Calls may be recorded