Align Technology Switzerland GmbH

Invoice
Ship To: Bashir , Ahmad Tax Registration #: GB337271403
3 Wratting Rd
Invoice #: 9066225405
Suffolk
Haverhill Invoice Date: 12.02.2024
CB9 0DA
Due Date: 13.03.2024
United Kingdom
Customer #: 1541375
Patient ID. #: 23211103
Shipment Date: 12.02.2024
Payment Terms: 30 days
Payer Tax #:
Page #: 1 of 1
Bill To: Bashir , Ahmad
3 Wratting Rd
Suffolk
Haverhill
CB9 0DA
United Kingdom

Additional Info: 1541375 - Bashir Ahmad

Item # Description Patient Name Qty Unit Price Order # Order Date Customer Tracking # GST/VAT Net Amount
/Chart # PO # /Carrier /TAX Rate
7883 Vivera Retainers Lucy Dare 1 200.00 227431825 09.02.2024 5119972826 20.00 % 200.00
( 03 sets U/L )
216581 Processing Fee Lucy Dare 1 10.00 227431825 09.02.2024 5119972826 20.00 % 10.00
Sub Total 210.00

GST/VAT/TAX 42.00

Shipping 0.00

Total Payment Due 252.00

Currency Code GBP
GST/ VAT/ TAX/ Shipping Tax
Breakdown
20.00 % 42.00

All products are subject to the terms and conditions set forth in the applicable Pricing, Terms and Conditions and/or Purchase Agreement. The total
payment due is inclusive of all discounts.

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Remittance Slip

Invoice #: 9066225405 Invoice Amount: 252.00 Payment Amount:

Payment Instructions:
Account Name: Align Technology Switzerland GmbH
Bank name: Citibank N.A., London Branch
Account: 11605046 Sort Code: 18-50-08
IBAN :GB03CITI18500811605046 SWIFT Code: CITIGB2L

Please include customer and invoice (s) number in your payment description.

Online Payments:
URL: https://payments-eu.invisalign.com
For questions you can contact us directly:
General Practitioner 0800-101-7006
Specialist Orthodontist 0800-101-7005.

Suurstoffi 22 Rotkreuz 6343 CH