In addition to any other provision in this chapter, each time a customer who receives a high-interest loan makes a payment to a licensee who operates a high-interest loan service, the licensee shall give to the customer a receipt with the following information:

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1.  The name and address of the licensee;

2.  The identification number assigned to the loan agreement or other information that identifies the high-interest loan;

3.  The date of the payment;

4.  The amount paid;

5.  The balance due on the high-interest loan or, when the customer makes a final payment, a statement that the high-interest loan is paid in full; and

6.  If more than one loan made by the licensee to the customer was outstanding at the time the payment was made, a statement indicating to which loan the payment was applied.