Purchase Order Format Sample

PURCHASE ORDER

[ Com pa ny Nam e] [ Yo ur C o m p a ny Slo g a n] [ S t r e e t A d d re s s ] [ C i ty, S T ZI P C o d e ] P h o n e [ ( 2 1 2 ) 4 4 4 - 0 1 2 3 ] Fa x [ ( 2 1 2 ) 4 4 4 - 0 1 4 4 ] The following number must appear on all related correspondence, shipping papers, and invoices: P.O . N U M BE R : [ 0 0 1 ]

TO :

S H I P TO :

[ Na m e ] [ C o m p a ny ] [Street Address] [City, ST ZIP Code] [Phone]

[ Na m e ] [ C o m p a ny ] [Street Address] [City, ST ZIP Code] [Phone]

P.O . D AT E

Q TY

R E Q UI S I T I O N E R

UNIT

S H I PP E D V I A

DESCRIPTION

F. O. B. PO I N T

TERMS

U N I T PR I C E

TOTA L

SUBTOTAL SALES TAX SHIPPING & HANDLING OTHER TOTAL 1. Please send two copies of your invoice. 2. Enter this order in accordance with the prices, terms, delivery method, and specifications listed above.

3. Please notify us immediately if you are unable to ship as specified.

4. Send all correspondence to: [Name] [Street Address] [City, ST ZIP Code] Phone [(212)444-0123] Fax [(212)444-0144]

Authorized by

Date