Business Payment Receipt

Receipt No: 001257
Date: 12/15/2057

Received From:

Name: Rocky Orn
Address: Houston, TX 77001
Contact: 222 555 7777

Item/Service	Quantity	Unit Price	Total
Web Design Service	1	$1,000.00	$1,000.00
Monthly Hosting Fee	1	$150.00	$150.00

Amount Paid: $1,150.00
Payment Method: Credit Card

Thank you for your payment!

[YOUR COMPANY NAME]
Authorized Signature: ______________________

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