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$____
LANIER_BROKEN/LOST/STOLEN STUDENT LAPTOP

REPLACEMENT COST FOR LOST/BROKEN/STOLEN COMPUTER

$660.00

PAYMENT PLAN OF 3 PAYMENTS AVAILABLE AS FOLLOWS:

INITIAL PAYMENT:     $300.00

2ND PAYMENT           $180.00

3RD PAYMENT            $180.00

For payment plan, once the amount is paid in full, your student will be issued another laptop.

Payment to: BOB LANIER MIDDLE SCHOOL
Item Amount: $____
+ Additional Fees:
Convenience Fee $0.31
Item Total $____

Amount:


The minimum amount is $1.00.

Additional Information Requested