TSA Contribution Invoice

This invoice is for a "Tax Sheltered Annuity Contribution"

invoice 6 page 001



1  -  Statement number ending in "T" indicates this is a "Tax Sheltered Annuity" contribution invoice.
2  -  This is the Member(s) lilsted on the TSA invoiceTSA amount due for this listed member "John Smith" .
3  -  This is the amount due for this listed individual member "Jane Smith".  The sum of all individual listed member amounts equals the total amount due.