PURCHASE ORDER

[COMPANY NAME]
[Company Slogan]
[Street Address]
[City, ST ZIP Code]
[Phone Number]
[Fax Number]

T O:

SH I P T O:

P. O. N U M B E R :

[Purchaser Name]
[Company Name]
[Street Address]
[City, ST ZIP Code]
[Phone Number]

[Recipient Name]
[Company Name]
[Street Address]
[City, ST ZIP Code]
[Phone Number]

[P.O. number]
[The P.O. number must
appear on all related
correspondence, shipping
papers, and invoices]

P. O D AT E

QTY

REQUISITIONER

UNIT

SHIPPED VIA

F. O. B . P O I N T

DESCRIPTION

TERMS

UNIT PRICE

[Description of Item]

$[4.00]

T O TA L

$[4.00]

S U B T O TA L
S A L E S TA X

1.
2.
3.
4.

Please send two copies of your invoice.

Enter this order in accordance with the prices, terms,
delivery method, and specifications listed above.
Please notify us immediately if you are unable to ship as
specified.
Send all correspondence to:
Laurel Yan
[Street Address]
[City, ST ZIP Code]
[Phone Number]
[Fax Number]

[8.2%]

SHIPPING AND HANDLING

OTHER
T O TA L

Authorized by Laurel Yan

$[4.33]