# | ID | First Name | Last Name | Middle Name | Address | TIN |  | Total Balance | Pay
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---

#### CUSTOMER PAYMENTS

Customer :

######

Address :

######

TIN :

######

ID |  | Order No. | Transaction Date | Due Date | Balance | Payment Id | Payment | Sub-Total | Sub-Total
--- | --- | --- | --- | --- | --- | --- | --- | --- | ---

| TOTAL BALANCE | 0.00
--- | --- | ---
| TOTAL SELECTED | 0.00

##### Total Amount Due:

#####

Bank:

Receipt #:
Check Number:
Check Date:
Amount:

CHANGE | 0.00
--- | ---

##### Total Amount Due:

#####

RECEIPT # |
--- | ---

CASH |
--- | ---

CHANGE | 0.00
--- | ---

##### Total Amount Due:

#####

Bank:

Receipt #:
Card Type:
Name on Card:
Card Number (LAST 4 DIGITS):
Reference:
Amount:

CHANGE | 0.00
--- | ---

##### Total Amount Due:

#####

Payment Method:

Receipt #:
Reference:
Amount:

CHANGE | 0.00
--- | ---