Your Company Name
Address: Street Address Phone: Phone number
Address 2 Fax: Fax number
City, ST ZIP Code Email: Email address
Statement
Statement #: Statement number Bill To: Name
Date: Date Company Name
Customer ID: Customer ID Street Address
Address 2
Remittance Amount Enclosed: Remittance amount City, ST ZIP Code
Date Type Invoice # Description Amount Payment Balance
Total 0
Reminder: Please include the statement number on your check.
Terms: Balance due in 30 days.
REMITTANCE
Customer Name: Name
Customer ID: Customer ID
Statement #: Statement number
Date: Date
Amount Due: $ -
Amount Enclosed: Remittance amount
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