To:

[Affiliate's Name]

Commission Period:

[Month Day, Year] - [Month Day, Year]

Commission Slip Number:

[00-000]

Earnings Summary

Sales Commissions:

Leads Commissions: 

Bonuses/Incentives:

Total Earnings:

Deductions (if any):

Deduction 1:

Deduction 2:

Total Deductions:

Total Amount Due: 

Payment Method:

• Credit Card

• PayPal

• Bank Transfer

Payment Date:

[Month Day, Year]