| ${r}Contact name (last, first) |
, | SS# | |||
|---|---|---|---|---|---|
| Company | |||||
| ${r}Address | |||||
| ${r}City | ${r}State/Country | ${r}Zip | |||
| Day Phone | |||||
| Night Phone | |||||
| Fax | |||||
| END print qq!Postal mail invoice |
| Email invoice ', qq! | Billing type |
| $paybychecked{$_} | !; } else { print qq!> $payby{$_}!; } } print <
| Username | |
| Password | (blank to generate) |
| POP | |