| AA | AB | AC | AD | AE | AF | |
| 5 | Card Holder Name | Minimum Payment | ||||
| 6 | ||||||
| 7 | Current Queue | Due Date | ||||
| 8 | ||||||
| 9 | Balance | Billing Days | ||||
| 10 | ||||||
| 11 | Past Due Amount | Date of Last Cycle | ||||
| 12 | ||||||
| 13 | Over Limit Amount | STD 1 | ADB | APR | ||
| 14 | ||||||
| 15 | Statement/Total Due | |||||
| 16 | STD 2 | ADB | APR | |||
| 17 | Days Past Due | |||||
| 18 | ||||||
| 19 | Broken Promises | STD 3 | ADB | APR | ||
| 20 | ||||||
| 21 | NIS Payments | |||||
| 22 | STD 4 | ADB | APR | |||
| 23 |