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1827:G01: 0-001827

JOHN DOE SMITH
109 ANGELA DR
DE LEON TX 76444

Customer's name and billing address
barcode

Billing Date

MAR 01, 2010

Customer's billing date

Delinquent After

MAR 16, 2010

Payment due date

Billing Number

254-893-3635

Customer's billing number

Account Number

0006639

Customer's member number

Amount Due

$

73.15

Total amount due (could include past due amount)

Amount Paid

$

Payment amount sent

Please send payment to:

TOTELCOM COMMUNICATIONS LLC
PO BOX 290
DE LEON TX  76444-0290

Address to send payments

PLEASE TEAR ALONG PERFORATION AND REMIT WITH PAYMENT

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