Print Ready ''Receipt'' Design with sequential numbering (Custom Design)

I need a Print Ready Business Form designed (Receipt). The Receipt will be printed on carbonless 2 part paper at my local FedEx (Kinkos) office so the finished files should be in a file format they will accept. The Receipt will have the following pre-filled information for my Business: [login to view URL] 3508 Chanate Ct. Santa Rosa, CA 95404 (888) 354-6660 TCP# 19855 The receipt will the word "Reciept" printed in large lettering on the form. Under this text will be the place the "Date" can be written. The receipt will have an area to write in: Client's Name Email Address: Phone number: The form will have the following column & rows (5 rows down will be fillable): Columns will be titled: Date of Service, Start Time, Finish Time, Type of Service, Region, Hourly Rate, Hours, and Total. At the bottom of the row will be a "Total Amount Due" box. At the end of the rows will be row of check boxes. PAID IN FULL BY CASH or CREDIT CARD. Another Text box will be labeled "Gratuity" and have empty space. The form will need to leave a spot blank for the numbering to be added to each invoice by the Printer. Form will be printed on 8.5" by 5.5" paper. If you have any questions please ask.