LEASE OF VIRTUAL SPACE Name: VAT (Tax Identification Number): Adress: Country:

Invoice

Value BRL

Company’s Name: Adress: Zip Code/ City/ State: CNPJ (VAT):

Issue Date

Due Date

Hi-Mídia S.A. Rua Bambina, 19. Botafogo 22.251-050 - Rio de Janeiro - RJ 07.456.778/0001-59 Description Lease of Virtual Space

Payment Informations (Bank Starts)

Value BRL

LEASE OF VIRTUAL SPACE

INSERT THE COMPANY BRAND

Name: VAT (Tax Identification Number): Adress:

FILL THE DATA WITH THE BENEFICIARY/ OWNER OF THE ACCOUNT

Country:

Invoice INSERT THE SEQUENTIAL

Value BRL

NUMBER OF THE INVOICE Company’s Name: Adress: Zip Code/ City/ State: CNPJ (VAT):

Issue Date INSERT THE ISSUE

Due Date INSERT THE DUE

DATE OF THE INVOICE

DATE OF THE INVOICE

Hi-Mídia S.A. Rua Bambina, 19. Botafogo 22.251-050 - Rio de Janeiro - RJ 07.456.778/0001-59 Description

Value BRL

Lease of Virtual Space

Payment Informations (Bank Starts)

FILLED WITH BANKING DATA FOR THE PAYMENT

VALUE OF PAYMENT