COMPANY NAME BILLING STATEMENT

BILL TO DATE
ATTN: Name / Dept
Company Name STATEMENT NO.
123 Main Street
Hamilton, OH 44416 CUSTOMER ID
(321) 456-7890
Email Address

REMIT TO
BALANCE DUE $ 200.00
Company Name
Address Line 1 To ensure proper credit, please
ensclose a copy of this statement DATE PYMNT DUE
Address Line 2
with your check. Please write your
Hamilton, OH 44416 Customer ID on your check.
AMT ENCLOSED $ -
Please make check payable to Your Company Name.

ACCOUNT ACTIVITY

DATE TYPE INVOICE DESCRIPTION PAYMENT AMOUNT BALANCE

BALANCE FORWARD $ 250.00

$ 100.00 $ 50.00 $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

$ - $ - $ 200.00

CURRENT BALANCE $ 200.00

For questions concerning this invoice, please contact Name, (321) 456-7890, Email Address

YOUR COMPANY NAME

123 Main Street, Hamilton, OH 44416
(321) 456-7890
Email Address | www.yourwebaddress.com

THANK YOU