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# | ID | Store Name | 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 #: Amount:

CHANGE | 0.00
--- | ---

##### Total Amount Due:

#####

Bank:

Receipt Number:
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
--- | ---