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Archived Online Payments

Form 7

Thank you, your payment has been made

Receipt Number: # 1234567890

Date: 2015-06-16 08:50:43

Card Name: VISADEBT
Card No.: xxxxxxxxxxxx9012
Auth Code: 354801
 
Total Amount: £445.00
 
Name: Jon Livingston
Billing Address: 28 STATION ROAD
STROOD
ROCHESTER
MEDWAY
ME2 4BG

If you provided a valid email address you will receive a receipt for this payment. If you were unable to provide a valid email address, please make a note of your receipt number for an future enquires.

<h1 class="heading-large">Thank you, your payment has been made</h1>

<div class="content-block">
    <p>Receipt Number: <b class="strong"># 1234567890</b></p>
    <p>Date: 2015-06-16 08:50:43</p>

    <table class="raw-table">
        <tr>
            <td>Card Name:</td>
            <td>VISADEBT</td>
        </tr>
        <tr>
            <td>Card No.:</td>
            <td>xxxxxxxxxxxx9012</td>
        </tr>
        <tr>
            <td>Auth Code:</td>
            <td>354801</td>
        </tr>
        <tr><td colspan="2">&nbsp;</td></tr>
        <tr>
            <td>Total Amount:</td>
            <td><span class="strong">£445.00</span></td>
        </tr>
        <tr><td colspan="2">&nbsp;</td></tr>
        <tr>
            <td>Name:</td>
            <td>Jon Livingston</td>
        </tr>
        <tr>
            <td>Billing Address:</td>
            <td>28 STATION ROAD<br>
                STROOD<br>
                ROCHESTER<br>
                MEDWAY<br>
                ME2 4BG
            </td>
        </tr>
    </table>

    <p>If you provided a valid email address you will receive a receipt for this payment. If you were unable to provide a valid email address, please make a note of your receipt number for an future enquires.</p>

    <div class="print-link">
        <a href="#" rel="nofollow" target="_blank">Print</a>
    </div>
</div>