A billing statement form is a document which focuses on the amount that a company or an individual has to pay for the products and services that he or she purchased from an enterprise. The figures which are stated in this form should be similar to the billing invoice that the selling enterprise have in their accounting records.

To allow the purchaser in completing his or her payment, he or she needs to present the billing statement form sample┬áto the cashiers or the accounting staff of the enterprise in order for them to search through their database system for the purchaser’s billing account, as well as to clear out any remaining balance.

Company Billing Statement Form

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Size: 49 KB

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Electronic Home Billing Statement Form

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Size: 351 KB

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Email Billing Statement Request Form

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Significant Sections in a Billing Statement Form

Even though billing statement forms centers on the purchaser or the client’s account, this document must have all the necessary data that aids the accountants and the clients in transacting the payment request successfully. Below are the significant sections of this document:

Company Name

As there are various companies who will be sending out statement forms to a client for different purchases that the client made, it is essential that the client will be able to distinguish which of the received documents came for their water and electricity bills.

Statement Date

This indicates the date when the statement form was sent and expected to be received by the client. Additionally, the account report number of the statement form is also included in this section.

Recipient’s Details

This section is also indicated as the “Bill To” section which states the recipient’s general information including his or her full account name and number, contact details and his or her address where the form is sent.

Sender’s Address

It is vital that the company who sent the form must indicate their contact information, company address and email addresses to let the recipient know where he or she will send the amount for the payment in events of wire transfer and online transactions.

The Subject of the Document

The subject section of the form states the main intention or action that needs to be completed by the client such as demanding a payment confirmation for registering his or her newly opened account, or for granting a payment due to the balance of the previous months which were left unpaid.

Account Summary

This section mainly indicates the total amount required for the client assessment to pay or the total amount of his or her remaining balance.

Due Date

Most payments must be made within the next thirty days after the document has been received by the client. With this, the due date indicates the specific day wherein the payment needs to be finalized to avoid dealing with associated penalties and fees.

Account Activity

A table of the client’s activities is in this section where the dates when the client made a transaction along with the transaction type, description of the purchase, business tax amount that associates the purchase, as well as the balance amount of the client, is stated.

Special Claims Billing Statement Form

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Size: 18 KB

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Monthly Billing Statement Form

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Size: 120 KB

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Company Billing Statement Form

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Types of Billing Statement Forms

Billing Statement Request Form – There are some companies who waits for the request of their clients before they grant the billing statement for the month. With this, a billing statement request form is provided to the clients in order for the company to gather ample information and data about the account. The request form┬ástates the personal information of the client which includes his or her name, phone number, email address, as well as an indication of whether the client is picking up the statement form or if he will let the company send the document after the request process.

Billing Statement Request Form

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Size: 607 KB

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Billing Statement of Responsibility Form – Educational institutions such as college universities are known to demand huge amounts of payments for their tuition fees and required books. To meet with the standards of these institutions, some students send out scholarship application forms to outside parties who can aid them in their school expenditures and projects.

These students has to complete a billing statement of financial responsibility form to indicate that they are aware of their financial responsibilities and obligations in an event that their sponsors is not able to provide the payments on time. This form also states the identification of the sponsors or the outside parties who will be helping the student, as well as the student’s essential information.

Billing Statement of Responsibility Form

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Burial Billing Statement Form – Obtaining a burial assistance may not be as easy in varying countries. However, this is done by the presentation of the legal forms that the assistance provider demands such as a burial billing statement form given by the funeral parlor.

This form contains the details of the person who filed for the assistance or the immediate relative of the deceased, the statement of the relatives, the specifications to be provided by the funeral parlor, as well as the deceased individual’s information. The costs that the funeral parlor needed as payment for the burial is stated in a table on the form to acquire a proper computation of all the employee expense.

Burial Billing Statement Form

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Delivery Billing Statement Form – When an item has been shipped and delivered to a client, the delivery man is handling the client a delivery order billing statement form to inform the client about the total amount that he needs to pay which includes the shipping fees and the separate product price.

The name of the payee or the client will be on the document as well as the client’s address, contact information, date of delivery, and the client’s payee account number. The individual prices of the products with their source units, quantity purchased, invoice dates and assigned numbers is also be stated in the form. It is vital that all the details of the purchased and delivered products are stated to let the client have a record of the payment breakdown for the transaction.

Delivery Billing Statement Form

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Duplicate Billing Statement Form – There are instances that a single billing statement may be needed and requested by two separate parties such as a financial aid provider and a client’s employer. With this, the client must submit a duplicate billing statement form to the authorized personnel who will be compiling his or her information and billing account. This form contains the list of the people or the parties where the client feedback permits to receive his or her billing statements along with the different addresses of each chosen recipient.

Duplicate Billing Statement Form

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Interpreter Billing Statement Form – An interpreter who has been hired by a client or an power of attorney needs to complete and submit an interpreter billing statement to the court. This document centers on specifying the hours that the interpreter has provided to the court and the details of the case where his or her expertise was used.

The interpreter’s name, address, identification number, language used and interpreted, the name of the case, judge’s name, and the place where his or her service forms were garnered are some of the data which can be found on the form. Another purpose why this document is requested by the court is due to the need of verifying the claims of the interpreter with regards to his or her presentation and payments.

Interpreter Billing Statement Form

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Lease Billing Statement Form – This statement form is used by real estate, commercial and residential rental landlords for their tenants. The landlord or the manager of the rental property has to highlight the payments that the tenant needs to supply for his or her stay in the premises in the lease application billing statement to properly aid the tenant in determining the allocations of the required rental fees. The description of the property and the months wherein the tenant was not able to pay will be on the form along with the total balance and payment due dates.

Lease Billing Statement Form

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Parking Permit Billing Statement Form – In schools and companies, a client who owns and drives a car needs to acquire a parking permit in order for him or her to grab a parking space in the premises of the organization. A parking permit application billing statement is provided to the client to allow him or her to start the permit registration process.

The form focuses on the client’s vehicle service information as well as the chosen method of payment that the client is able to provide regularly. The client’s signature serves as a certification that the client is aware with regards to his or her high responsibility for the cars or the vehicles that he or she had listed on the statement form.

Parking Permit Billing Statement Form

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Pharmacy Billing Statement Form – A patient who is enrolled in an insurance coverage will be receiving a hospital assistance in the duration of his or her stay in the hospital as well as whenever there is a need to supply medication as requested by a licensed medical physician.

With this, a pharmacy billing statement form should be submitted to the insurance carrier of the patient to begin the transaction of providing the requested medicine and services. The form has a patient information section along with the details of the prescribed medicine and the patient’s employer who have registered the patient to an insurance account.

Pharmacy Billing Statement Form

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With the varying types of billing statement forms, it is essential that a company must only indicate the exact amount needed for clearing the client’s account for a particular period and should always show the breakdown of the request. Additionally, the client should also provide the right information to the company prior to his or her purchase to avoid a conflict with the upcoming transactions and purchase order that he or she will be doing.

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