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Tom Exemple
Speech therapist, INAMI no. 6-00022-20-222
Rue de la Démonstration 1, 1000 Bruxelles
Tel. 0400 00 00 00 · demonstration@exemple.be
Enterprise no. 0234.567.873
To the parents of Simon Nathan
For the attention of Parent de Nathan
Rue de l'Exemple 1
1000 Bruxelles
Bruxelles, on 25 October 2026

Payment reminder

Invoice no. TE-2026-003 of 25/10/2026

Sessions of September 2026

Dear Sir or Madam,

Unless we are mistaken, invoice no. TE-2026-003 of 25/10/2026, for the speech therapy sessions of September 2026, has not yet been paid in full.

Personal share payable by you6,00 €
Left to pay6,00 €

Please pay this amount into account BE68 5390 0754 7034 in the name of Tom Exemple, with the structured reference +++202/6020/00315+++, or settle it at your next session.

Or scan this code with your banking app: everything fills in by itself.

If you have paid in the meantime, please disregard this reminder.

Yours faithfully,

Tom Exemple