Billing Statement Form

October 1, 2010 | By | Reply More

A billing statement form is used for invoice tracking, general billing purposes, and customer account management. The format of billing statement form varies according to the requirement and as per organization. This statement form is consisting of a number of columns, rows, customer details and organization address.

Sample Billing Statement Form:

Name of the company: _______________

Bill No: _________________

Street Address: _____________________

Statement #: ______________

City, ST, ZIP: ______________________

Customer ID: ______________

Valid contact number: _______________

Date of Billing: _____________

Remittance:

Enclose a copy of statement, to ensure a proper credit:

Company Name: ______________

Company Address: ____________

Zip: ______________

Do mention your customer ID on the cheque book.

Account Summary:

Total Payment Made:

  • Balance Due:
  • Payment Due:
  • Taxes:
  • Other:

Make all cheques Payable to following details:

Company Name: _______________________

Account Activity:

DateTypeInvoice DescriptionPayment madeAmountBalance
Balance forward
Payment received
Payment due
Late fees
Total Late Fees
Previous balance
Current balance

Signature: ___________________

In case of any query, please feel free to contact us or visit at the give address details:

Name: ______________________

Street Address: _______________

ZIP: _______________________

Phone: _____________________

E-mail: _____________________

Thanks you for your Business!

Category: Statement Forms

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