Statement
[MEMBER_ID]
[MEMBER_NAME]
[ADDRESS1]
[ADDRESS2]
[ADDRESS3]
[CITY],[STATE]
[COUNTRY]
[ZIP]
Statement Date
[BILL_DATE]
For the period
[BILL_PERIOD]
Annual Subscription Billing
Current Year Charges
Paid
Payable
[BILL_DETAILS]
[BILL_DETAILS]
[BILL_DETAILS]
(Rupees: Thirty Eight Thousand Nine Hundrade Seventy Six Only)