Notice and Direction
TO: Name of Account Payor
TAKE NOTICE that the undersigned has assigned to Name of Assignee (Person to whom payor is indebted) (the "Assignee") the following account(s).
Date of Account Date of Account Invoice Number Invoice Number Amount Amount of Account Terms of Payment Terms of Payment (ie. Due on Receipt, Net 30 Days, etc.) Terms of Payment (ie. Due on Receipt, Net 30 Days, etc.)
Date of Account
Invoice Number
Amount of Account
You are hereby authorized and directed to make payment of the Account(s) directly to the Assignee as follows: Name of Assignee Address of Assignee Telephone No. of Assignee
Dated:
Witness
Name of Person Making Assignment of Account(s)