INVOICE

True Bill / Civil Assessment

No. 01012019A (Month, day, year) Date: x / xx / 2019
Attachment to Invoice No. 01012019A Due Date: x / xx / 2019 (30 days later)
^^REMOVE IF FIRST INVOICE^^ LATE FEES NOW ACCUMULATING!
(Include this on 2nd invoice)

Obligee: First-Middle: Last

c/o 1234 Your Address St.
City, State Republic, near [ 12345 ]
without the UNITED STATES

Obligor: Attention: C.F.O. of

CORPORATION NAME HERE
1234 THEIR ADDRESS ST.
CITY, ST 12345

Billing Details with Description Provided

Description Item Amount per Amount
Count Item
Copyright use without permission --
Month, 2019
X $15000 $15000 x “X”

Previously Billed per Invoices # xxxxxxx, xxxxxxx

(REMOVE THIS TABLE IF FIRST INVOICE)
Description Item Amount per Amount
Count Item
Copyright use without permission --
Month, 2019
X $15000 $30000
Copyright use without permission --
Month, 2019
X $15000 $60000

Late Fees
(REMOVE THIS TABLE IF FIRST INVOICE)
Schedule Days Total
$1000 per day
X $1000 x “X”
(after 30 days elapses)

Billing Totals

Copyright use without permission Items: X

As payable at a ratio of 24:1

24 x $15000 x X counts
Silver Bullion to F.R.N.’s
Late Fees (REMOVE THIS ROW IF FIRST INVOICE) $LATE FEES
Total $TOTAL SUM (sum + late fees)

- Please make all checks / promissory notes payable

to First-Middle: Last at the mailing address
provided.
- All invoices are due within 30 days of receipt by By:
the Obligor along with applicable late fees. First-Middle: Last for
- Amounts have been denoted in fine silver bullion FIRST MIDDLE LAST, Estate
pursuant to Article I, Section X of the U.S. Autograph Common Law Copyright, © 2019
Constitution.