New Helfta Atelier PO Box 464 . Geneseo, NY 14454

Tel. 585-245-8612 Fax 585-245-8613 Email: minhkh@rochester.rr.com Web site: www.ourladyofnewhelfta.com

 

 

Invoice

Invoice No.: _______________

(1st, 2nd or 3rd )

Invoice Date: _______________

 

 

 

Patron/contact person: ______________________________________________________

 

Address: _____________________________________________________________________________________

 

 

City/State: ____________________________________________________ Zip code: ______________________

 

 

Phone: _____________________________________________ Fax: _____________________________________

 

 

 

Item # Type of Service/ Sale/ Comments Quantity Amount

 

 

1

 

 




 

2

 

 

 

 

 

3

 

 

 

 

4

 

 

 

 

 

5

 

 

 

 

 

Subtotal: __________

Tax: __________

( New York residents add your tax to the above Subtotal. Tax

Exempt organizations, please include certificate with order)

Shipping and handling: __________

Amount due: ________ Amount Paid: ___________ Amount remains: ________


Please make check payable to New Helfta Atelier

 

Due date: ________ Amount enclosed: _________

 

 

 

 

Signed: ________________________________________________ Date : ____________________

(Patron / contact person)

 

Print name: ______________________________________________________________________

 

Please sign, date and return one copy with payment. Thank you for your business.


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