Statement

Company slogan	Date Date Statement # 100
Company Name Street Address City, ST ZIP Code Phone phone Fax fax Email	BILL TO	Name Company Name Street Address City, ST ZIP Code Phone phone Customer ID ABC123	COMMENTS	Comments
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 Company Name

Thank you for your business!