Invoice SN: 123456789

Invoiced to

Mavis Schmeler
1904 Coolidge St
Brownsville, Texas 78521
United States

Pay to

Miller, Romaguera and Spinka
853 Burwell Heights Road
Nederland, Texas 77627
United States
EIN: 25-3243963
Bank Account Number: 23961707
Item Qty Price Total
Product #1234 1 $500.00 $500.00
Product #1235 2 $250.00 $500.00
Product #1236 4 $100.00 $400.00
Sub Total: $1400.00
Tax: 27%
Total: $1778.00