STATEMENT
[Your Company Slogan]	Date: [Click to select date] STATEMENT # [No.]
Comments	Bill To	[Name] [Company Name] [Street Address] [City, ST ZIP Code] [Phone] Customer ID [ABC12345]

Date	Description	Balance	Amount
Current	1-30 Days Past Due	31-60 Days Past Due	61-90 Days Past Due	Over 90 Days Past Due	Amount Due

Remittance
Statement #	100
Date
Amount Due
Amount Enclosed

Make all checks payable to [Your Company Name]

Thank you for your business!

[Your Company Name] [Street Address], [City, ST ZIP Code] Phone [phone] Fax [fax] [email]