"First Name" field is required.

"Last Name" field is required.

"Street Address" field is required.

"City" field is required.

"ZIP Code" field is required.

"State" field is required.

"Country" field is required.

"Cardholder Name" field is required.

"Card Number" field is required.

"Expiration Date" field is required.

"Security Code" field is required.

Card Or Magstripe Required

Payment Amount

Select or enter your payment amount below.

Current balance $222.00

Minimum payment amount $5.00

Other amount $ Minimum payment amount is $5.00.

Billing

First Name *

Last Name *

Street Address *

City *

ZIP Code *

State *

Country *

Credit Card

Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Billing

First Name *

Last Name *

Street Address *

City *

ZIP Code *

State *

Country *

Credit Card

Cardholder Name *

Card Number *

Expiration Date *

Security Code *

Invoice 200

Make Payment Pay Invoice

From: Ohr Yitzchok Radvil
Cong. Ohr Yitzchok Radvil
174 Maple Ave.
Monsey, , NY 10952
US

To: רייזמאן מרדכי בצלאל

Date: November 11, 2022

Invoice Number: 200

Invoice Due: November 25, 2022

Invoice Total: $222.00

Balance: $222.00

Task

Rate

Qty

Amount

ראש השנה יום א’ עלה שני

$54

1

$54
יום א’ שבועות עלה שני

$18

1

$18
זיץ פ”ד

$150

1

$150

Notes

Checks paypable to: Cong. Ohr Yitzchok Radvil
174 Maple Ave. Monsey, NY 10952

Terms

Please review your invoice and make payment at your earliest convenience.