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BILLING STATEMENT I-Billing - Internet Billing for your ISP 1234 Something Street Suite #101 Atlanta, GA 30001 John Doe 987 Somewhere Ave San Fransisco, CA

90001

Reg. Number: 23498756 From: Oct 01, 2003 To: Nov 17, 2003 Due upon receipt Payment enclosed: ___________ -----------------------------------------------------------------------(Trim here and return upper portion) BILLING STATEMENT I-Billing - Internet Billing for your ISP 1234 Something Street Suite #101 Atlanta, GA 30001 -----------------------------------------------------------------------Date Service description Amount -----------------------------------------------------------------------Oct 16, 2003 CC Payment -- 118906 -- Thank You 4.95 CR -----------------------------------------------------------------------Oct 17, 2003 Special: GreatISP 56K Unlimited 4.95 Internet Access -- Login User name: JohnDoe333 -- Ongoing fee fromOct 17, 2003 toNov 16, 2003 -----------------------------------------------------------------------Nov 16, 2003 CC Payment -- 118929 -- Thank You 4.95 CR -----------------------------------------------------------------------Nov 17, 2003 Special: GreatISP 56K Unlimited 4.95 Internet Access -- Login User name: JohnDoe333 -- Ongoing fee fromNov 17, 2003 toDec 16, 2003 -----------------------------------------------------------------------Previous balance 0.00 -----------------------------------------------------------------------Amount due 0.00 -----------------------------------------------------------------------Please include Registration # on remittance.

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Sample PDF - Billing Statement

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