Separate before paying in

Receipt

Account / Payable to

CH44 3199 9123 0008 8901 2
Thomas LeClaire
Rue examplaire 22a
1000 Lausanne

Reference

12 34567 89012 34567 89012 34567

Payable by (name/address)

Currency

CHF

Amount

25.90

Acceptance point

Payment part

Currency

CHF

Amount

25.90

Account / Payable to

CH44 3199 9123 0008 8901 2
Thomas LeClaire
Rue examplaire 22a
1000 Lausanne

Reference

12 34567 89012 34567 89012 34567

Additional information

Invoice 1234568
Gardening work
Bill Information

Payable by (name/address)