Purchase Order Form Company Logo and Name: (Ref. PUR-010)
Purchase Order Form Company Logo and Name: (Ref. PUR-010)
Issue date:
Purchase Order Form
(Ref. PUR-010)
File Location: Date Printed: Page 1 of 1
Order Date
Shipping Date
PO Number
COMPANY LOGO AND NAME
Vendor Number
Vendor Fax #
Vendor Name
Address:
Authorization number
Shipping charges Paid: or collect:
Person Authorizing Return
Shipping Address:
Item # Material Code Approved Description Qty. required Vendor Invoice # Unit Price Total Amount
Reason for Return Action Requested Sub Total
1. Overstock 1. Repair and Return Tax
2. Over-shipment on PO# 2. Repair and Bill Handling / Shipping Charges
3. Substitution on PO # 3. Replace at no Charge Total
4. Defective 4. Issue Full Credit
5. Other 5. Other