CONVERGE INFORMATION AND COMMUNICATIONS

TECHNOLOGY SOLUTIONS, INC

Reliance Center Annex 1, #99 E. Rodriguez Jr. Avenue, Bo. Ugong. Pasig City 1604
Tel. No.: (045) 598-3088 / (02) 667-0888
VAT Reg. TIN: 006-895-049-000

STATEMENT OF ACCOUNT

Account Number SOA Number

RAFOLS ALLAN ROY
DOLMAR GOLDEN HILLS BLK21 LOT22 SAN 0020151211262 0020151211262-0321
VICENTE SANTA MARIA BULACAN
Statement Date Billing Period
March 11, 2021 March 6, 2021 -
April 5, 2021

Minimum Due Total Amount Due Date Plan

PHP 1,774.19 PHP 1,774.19 April 10, 2021 FIBER X 2500 100MBPS
(NO DEPOSIT) - 1
MONTH FREE

PREVIOUS CHARGES:
Previous Bill balance PHP 2,500.00
Payments received (Thank you) PHP 2,500.00
Add Adjustment PHP 0.00
Remaining balance from Previous Bill PHP 0.00
CURRENT CHARGES:
Main line fee March 15, 2021 - 1,584.10
April 5, 2021
VAT 190.09
Total Current Charges PHP 1,774.19
TOTAL AMOUNT DUE: PHP 1,774.19

IMPORTANT REMINDERS
Thank you for paying your monthly subscription fees promptly. We appreciate your efforts for keeping
your account updated from time to time. Rest assured that we are doing our best to provide you only
the best quality internet service. Please examine the charges in your statement of account and
advise our Billing Department of any discrepancy within 15 days from statement date, otherwise this
statement of account will be considered correct.

Please attach this billing stub when making payments

Account number: 0020151211262 Due Date: April 10, 2021

Name: RAFOLS ALLAN ROY Total Amount Due: PHP 1,774.19
SOA number: 0020151211262-0321
Contact no.: 09983133820

Ì0020151211262-0321-PS-11774993nÎ
0020151211262-0321-PS-11774993

SOA number: 0020151211262-0321 Due Date: April 10, 2021

Received by: _________________________________ _________________________________

Signature over Printed Name Date and Time