THA INC PERSONAL PAYMENTS PAGE(HOME, AUTO, HEALTH)

To: Toby Hansen Agency Inc.

THA INC PERSONAL INSURANCE PAYMENTS (HOME, AUTO, TOYS, HEALTH)

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Payer Information

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Payment Amount:

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e-Check

Fee: $1.00

Amount: ~n/d~

Processing time: up to 5 business days

~ CHECK  ~
~ ADDRESS ~
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~BANK & ACCOUNT~
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Your Receipt Pages

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Unpaid Items for

$podatak.amount_str INVOICE
Created on: podatak.createdOn_str
Due Date: podatak.dueDate_str
podatak.paymentFor
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(i.e.: john.doe@mail.net, anna@mail.net,jack.smith@mymail.org)

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