Purchase Order

[COMPANY NAME]

[ Street Address]

[ City, State Zip Code]

Phone: [PHONE NUMBER]

Fax: [FAX NUMBER]

[INTERNET ADDRESS]

ORDER INFORMATION

Date of Order: [DATE]

Salesperson: [Name]

O rder Number: [ number]

Terms: [INSERT TERMS, I.E., NET 15 DAYS, COD, ETC.]

Special Instructions: [DESCRIBE, IF ANY]

BILL TO:

SHIP TO:

[Name]

[Company]

[Street Address]

[City, State Zip Code]

[phone number]

[Name]

[Company]

[Street Address]

[City, State Zip Code]

[phone number]