[ URL ftp://rs.internic.net/templates/sample-invoice.txt ] [ 10/95 ] **************************************************************************** SAMPLE INVOICE This is an example invoice that will be sent within seven days after your registration of your domain with the InterNIC. On the new domain template there is an option to have your invoice delivered to you either by postal mail or by electronic mail to the billing contact. If the billing contact does not exist, the invoice will be delivered to the administrative contact. You then can remit payment to the InterNIC either by fax (for credit cards and pre-established accounts only) or by postal mail. The information is listed below. **************************************************************************** PAYOR: DATE: 19-sep-1995 John Doe My Internet Company, Inc. 11 Main Street Anytown, Anywhere 94402 AnyCountry PAYEE: InterNIC Registration Services P.O. Box 1656 Herndon, VA 22070 US FAX: +1 (703) 742-4811 E-MAIL: invoice@internic.net **************************************************************************** INVOICE FOR DOMAIN REGISTRATION & RENEWAL ******************* Please DO NOT REMOVE Version Number ******************** Invoice Version Number: 1.0 **************** Please see attached detailed instructions ***************** Invoice Information 1a. Invoice Number......................: 950915.1 1b. Invoice Date........................: 15-sep-1995 1c. Invoice Due Date....................: 14-nov-1995 Domain Information 2a. Registered Domain Name..............: DOMAIN.COM 2b. Associated Tracking Number..........: 950829.78 2c. Initial Registration Fee............: $100.00 USD 2d. (A)ccept (R)eject Charge............: Summary Information 3a. Total Charges.......................: $100.00 USD 3b. Total Amount Accepted...............: Payment Method 4a. (CH)eck, (CR)edit card, or (AC)count: Credit Card Payment Information 5a. (V)isa, (M)astercard, or (A)MEX.....: 5b. Credit Card Number..................: 5c. Name on Credit Card.................: 5d. Expiration Date.....................: 5e. Authorized Signature and Date.......: Account Payment Information 6a. Account Number (5-Digit)............: --------------------------------- cut here --------------------------------- GENERAL INSTRUCTIONS The form above details the domain name(s) you have registered and offers three possible payment methods. Use this form to indicate your acceptance and payment of domain names. THIS FORM AND YOUR PAYMENT IN US DOLLARS (USD) SHOULD BE REMITTED EITHER BY POSTAL MAIL OR BY FAX. The mailing address is: InterNIC Registration Services P.O. Box 1656 Herndon, VA 22070 The fax number is: +1 (703) 742-4811 Please do NOT remit payment information electronically. Questions concerning this form should be directed to billing@internic.net. If this form and your payment are received by the due date, your use of the domain name(s) will continue. The invoice due date is shown in item 1c. You will receive a reminder message 10 days before the due date if payment has not been received. The payment MUST be received by the due date in order for your use of the domain name(s) to continue. This form MUST accompany your payment in order for payment to be processed, unless you are paying for only one domain by check. In that case, you may simply write the domain name on your check. Your canceled check or credit card statement serves as your receipt. Please do not modify the form nor remove the version number. The instructions for completing each field follow. Please read the instructions carefully and make sure the form is properly completed to accomplish the action you desire. Section 1 - Invoice Information Do not alter these fields. Your payment is due on the date shown in item 1c. Section 2 - Domain Information Do not alter items 2a, 2b or 2c. In item 2d, please place the character "A" or the word "ACCEPT" to indicate your acceptance of and intent to pay this domain. If, for any reason, the domain is unacceptable, please indicate such with the character "R" or the word "REJECT." A domain that is "rejected" will be considered unregistered and will be returned to the free pool. Section 3 - Summary Information Do not alter item 3a. The sum of the fees associated with those domains you have accepted should be placed in item 3b. This is the amount of your payment. Section 4 - Payment Method Indicate the payment method you prefer in item 4. Enter "CK" or the word "CHECK" if paying by check. Enter "CR" or the word "CREDIT" if paying by credit card. Enter "AC" or the word "ACCOUNT" if paying on account. Section 5 - Credit Card Payment Information If paying by check or on account, this section should be left blank. If paying by credit card please list the name of the card in item 5a. Please use either a "V" (or the word "Visa"), an "M" (or the word "Mastercard") or an "A" (or the word "AMEX"). List your credit card number in item 5b. The name, as it appears on your credit card, should be written in item 5c. The credit card expiration date should be listed in item 5d. Your signature and date should appear in item 5e. Section 6 - Account Payment Information THIS SECTION IS FOR USE BY INTERNET SERVICE PROVIDERS ONLY. Complete item 6 only if you intend to pay on account. To pay on account, you must first complete the Account Application Form available at ftp://rs.internic.net/templates/account-template.txt and submit it with your initial payment. After your Application Form and payment have been received, you will be assigned a 5-digit Account Number. You may then charge your registration fees against your account by writing your account number in item 6.