[COMPANY NAME] Purchase Order

[Your Company Slogan Here] Date: 2/2/2017

[Street Address] Customer ID: [ABC12345]
[City, ST ZIP Code]
[Phone]

To: Ship to P.O. Number

[Purchaser Name] [Recipient Name] P.O. #
[Company Name] [Company Name] [The P.O. number must appear on
all related correspondence,
[Street Address] [Street Address] shipping papers, and invoices]
[City, ST ZIP Code] [City, ST ZIP Code]
[Phone] [Phone]

P.O DATE REQUISITIONER SHIPPED VIA SHIPPED VIA TERMS

Pick the Date

Qty Unit Description Job Unit Price Line Total

45.00 $ 10.00 $ 450.00

50.00 20.00 1,000.00

1. Please send two copies of your invoice. Subtotal $ 1,450.00

2. Enter this order in accordance with the prices, terms, delivery method, and
specifications listed above. Sales Tax 5%
3. Please notifiy us immediately if you are unable to ship as specified.
4. Send all correspondence to: SHIPPING & HANDLING 28.00
[Name]
[Street Address] Other 100.00
[City, ST ZIP Code]
[Phone] Total $ 1,650.50
[Fax]

Authorized by Date

[Street Address], [City, ST ZIP Code] [Phone] [Fax] [E-mail]