Payment Coupon

Account Number 2827

Gold Cross Answering Service Invoice Date 12/01/2009
Po Box 1245 Invoice Number 09120102827
Eau Claire, WI 54702 Payment Due Date 12/11/2009
Balance Due $89.68

Amount Enclosed $

OAKWOOD HOMES AND LONDON SQUARE APARTMENTS

3802 DAMON ST
EAU CLAIRE, WI 54701

Make checks payable to: Gold Cross Answering Service

Please return upper portion with remittance, thank you!
Account Summary Aging Summary
Account Number 2827 Net Charges $85.00 Current $89.68
Previous Balance $93.37 Sales Tax $4.68 30+ days $0.00
Payments Received -$93.37 Current Charges $89.68 60+ days $0.00
Balance Forward $0.00 Total Charges $89.68 90+ days $0.00
Current Credits $0.00
Balance Due $89.68

Thank you for your prompt payment.

Activity Summary Invoice Number: 09120102827 Invoice Date: 12/01/2009

Date Quantity Description of Service(s) Total ($)
11/23/2009 Thank You For you Payment -43.88
Thank You For you Payment -49.49
12/01/2009 BASE RATE 42.20
20 FAXES 10.55
64 INCOMING 33.76
6 OUTGOING 3.17
Balance Due $89.68
Notes:
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Gold Cross Answering Service | Po Box 1245 | Eau Claire, WI 54702 | 715-839-9668