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Request for Payment FREE & HIGH QUALITY

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					88. Request for Payment
From:
________________________________________
________________________________________
________________________________________
________________________________________
To:
________________________________________
________________________________________
________________________________________
________________________________________
Date _______________
Dear Customer:
We have received your order and promptly processed the order according to your instructions.
Please send the amount listed below immediately. Payment is expected in the form of a check,
money order, VISA, or MasterCard. Please place the reference number on your payment. We
appreciate your interest in our product/service and your prompt attention to this matter.
Thank you.


Accounting Department
Amount $ ________________________________ Reference # __________________________
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From:
Check payment $ ________________ Check # ____________________
To Charge a Credit Card: please fill out the following:
___________________________________________________________ __________________
Type: VISA/MasterCard/American Express Card Number                                        Exp. Date
___________________________________ _______________________ _________________
Credit Card Billing Address
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________

				
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Description: Request for Payment FREE & HIGH QUALITY