 
                    
                            User Number
                            
                                
                            
                        
                    
                                    
                                        Debt
                                    
                                    
                                
                                                                
                                    
                                        Abonent Name
                                    
                                    
                                
                                                                
                                    
                                        Address
                                    
                                    
                                
                                                        
                            
                            
                                PAYMENT AMOUNT                            
                            
                                
                            
                            
                        
                        
                            
                                Fee                            
                            
                        
                        
                            
                                Total                            
                            
                        
                        
                            
                                Amount:                                 min. 0.5a                                 max. 1000a                                | Commission Fee:                                                                 0.5a                                                                                            
                        
                     
                                     
                                
                        
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