* eS TATEMENT.
oreose pe
ae ‘000001505617
|__Due upon receipt |
2.855.4 PET
Make Payment To:
‘Call international, no
'800-STOR-CEL (800-786-7235) $126.88
‘ALL TOR AADC 0s PAGE:
LOURDES COLON
URB PONCE DE LEON,
16 CALLE CAPARRA,
-MAYAGUEZ, PR 00680 uzeeet 1 Address correction requested.
(Please complete reverse side.)
by
1D Payment by credit card
(Please complete reverse side.)
5/31/2019 Balance Brought Forward $125.00
FCHRG0606418 6/5/2019 June 2019 Finance Charge $1.88
To receive your statements via email, please go to our website, hutpa://www.cryo eell.comMresourcew/request
forms/change-of- address to provide or update your email address.
Cryo-Cell will begin charging 1.5% interest on all balances 30 days pastdue,
AMOUNT DUE, USD $126.88
Alondra Nieves (000001505617
Payable by check, money order or credit card.
To ensure proper credit to your account, please
include your Client ID number with your payment.
‘Your account is past due. Please remit payment today.
0-30Day» S1-00Dms —GL-SODAYS 91 ISU Lays
S188 0.00 $125.00 $0.00
181 20Des 211-265 Dow OEE nr You For Choosing GRYO-CELL Internationa ne.ADDRESS CHANGE: :
1 Biting Contact C1 Mother (1 Father (Check al that app) Cen 1D numbers) fra specimens store at Gyo-Cal:
Customer Name!
aoress:
caren mat cores:
tye State: Ze: 1 Mother.
“elophone Number: 2 1 Father
11 BILL To CREDIT caRD:
Visa) Mastercard) Amefcan Express Discover Diners Ch
Name of Cardholder: x
‘Adress, City, State, Zp
Care Number: = Expiration Date:
‘Authorized Signature:
(D_ENROLL IN AUTOMATIC PAYMENT PLAN: CI¥es [No
Fominder Crest ca proviced wil utoratioally be charged forthe annual torage fee each year king the month ofthe chic birthday