Sample Payment Note

Payment Date: November 21, 2050
Amount: $500.00
Payment Method: Bank Transfer

Payee:
[Your Name]
1234 Maple Street
Cityville, ST 12345

Payer:
ABC Corporation
5678 Oak Avenue
Cityville, ST 67890

Purpose of Payment: Payment for invoice #12345 for consulting services rendered in October 2024.

Reference Number: INV-12345-2024

Acknowledgment:

I, [Your Name], acknowledge the receipt of the payment as specified above.

Signature:

Authorized by:
ABC Corporation
Signature