[Company Name] Payment Receipt	Sold BY:	Date
Name:
Address
Cash	Charge	C.O.D	ON.ACCT	Estimate
QTY.	Details	Price	Amount
Received BY:
Thank You for Your Business! [Street Address], [City, ST ZIP Code]
[Phone: 555-555-55555] [Fax: 123-123-123456]
[abc@example.com]