PROFORMA INVOICE Bill From Bill To Invoice No. fashion Name: Maryurys Exporter Name: Zharith import Company Name: textile sas Company Name: international fashion distributor Ltda Invoice Date: 18/06/2024 Street Address: Fashion Avenue 123, Cartagena Colombia Street Address: 456 elegance street City, ST ZIP Code: _12345 City, ST ZIP Code: 54321 Due Date: 20/07/2024 Phone: +57 3023837414 Phone: +987654231 Description Quantity Price ($) Total ($) evening dress (model: elegance) 200 50 10.000 dress shirt (variety: classic) 500 30 15.000 shorts 300 25 7.500 Subtotal 32.500 Sales Tax 0 Other Shipping 2,000 Total 34,500 Terms and Conditions Thank you for your business. Please send payment within __30____ days of receiving this invoice. There will be a _1,8_____% per _ month change _____ on late invoices. Page 1 of 2 Please Choose a Payment Type Credit Card ☐ Visa ☐ MasterCard ☐ Discover ☐ American Express Cardholder Name zharith import Account/CC Number 67548931278 Expiration Date 12 /2024 CVV 456 Zip Code 45321 I authorize the above named business/individual to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one (1) time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. SIGNATURE Zharith Narvaez (cardholder name) DATE 18/06/2024 Bank Wire Name on Bank Account: Zharith import Street Address: 456 elegance street Bank Name: international import bank Account Number: 0987654321 Routing Number: 852432 Account Type: cheking Email: [email protected] Page 2 of 2
