Purchase Order Home » Services » Purchase Order Purchase Order Step 1 of 12 8% User Email* What is the purchase order number and date on which the purchase will be made? Order number: Purchase date: MM slash DD slash YYYY Who is placing the order? Purchaser Name: Address Address: City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone number: Email PDF Preview Who is the Vendor? Vendor Company Name: Address Address: City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone number: Email Website PDF Preview How many unique items are being purchased from the Vendor? Number of unique items: 12345 PDF Preview What is the first item you would like to add to this purchase order? What is the item (or service)?: What is the quantity ordered?: What is the price ($) per unit for this item?: What is the item ID number (if available)?: PDF Preview What is the second item you would like to add to this purchase order? What is the item (or service)?: What is the quantity ordered?: What is the price ($) per unit for this item?: What is the item ID number (if available)?: PDF Preview Please provide the following information for the third item being purchased. What is the item (or service)?: What is the quantity ordered?: What is the price ($) per unit for this item?: What is the item ID number (if available)?: PDF Preview Please provide the following information for the fourth item being purchased. What is the item (or service)?: What is the quantity ordered?: What is the price ($) per unit for this item?: What is the item ID number (if available)?: PDF Preview Please provide the following information for the fifth item being purchased. What is the item (or service)?: What is the quantity ordered?: What is the price ($) per unit for this item?: What is the item ID number (if available)?: PDF Preview What is the tax rate that will apply to this transaction? Tax rate (%): Total tax ($): How will the order be shipped? Shipping service (e.g. USPS, Fedex): Shipping method (e.g. overnight delivery, 2-day shipping): Expected delivery date: MM slash DD slash YYYY Shipping charge ($): PDF Preview Is there going to be a discount given for this transaction? Discount?: Yes No Discount rate (%): Discount ($): PDF Preview Where will the order be delivered? Company name: Recipient name: Address Address: City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code PDF Preview PDF Preview ${input_25_6} ${input_25_7_2}, ${input_25_7_3},${input_25_7_4},${input_25_7_5} Phone : PURCHASE ORDER P.O. # ${input_25_3} ORDER DATE: ${input_25_4} VENDOR ${input_25_12}, ${input_25_13_2}, ${input_25_13_3},${input_25_13_4},${input_25_13_5} Phone : SHIP TO ${input_25_67} ${input_25_68} ${input_25_69_2} ${input_25_69_3},${input_25_69_4},${input_25_69_5} SHIPPING SERVICE SHIPPING METHOD DELIVERY DATE ${input_25_56} ${input_25_57} ${input_25_58} Quantity Item # Description Unit Price Line Total ${input_25_22} ${input_25_23} ${input_25_24} ${input_25_25} $0.00 Subtotal $0.00 Sales Tax ${input_25_53} Shipping Charge ${input_25_59} Order Total $0.00 __________________________________ Vendor Signature __________________________________ Customer Signature
