CBA Record September 2017

Proud Member Benefit Provider

Pay Invoice

PCI Compliant

Invoice Payment Payment Detail

Cook Brooks Johnson PLLC

Amount to Pay* Invoice Number Amount to Pay Invoice Number

Cooks Brooks Johnson 123 Main St. City, State 23451 Phone: (123) 345-4751 Email: payments@cbj.com Web: www.cbjlawfirm.com

Matter Number Matter Number Cardholder Informatio

n

Name

Name

Pay Invoice

Month

ar

Ye

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