Warning:
These forms are provided AS IS.  They may not be any good.  Even if they are good in one state or jurisdiction, they may not work in another.  And the facts of your situation may make these forms inappropriate for you.  They are for informational purposes only, and you should consult an attorney before using them.

CONFIRMATION OF PURCHASE ORDER

  ORDER DATE: ______________________

P. O. # : _______________

BILL TO: SHIP TO:

__________________________________ ______________________________    

__________________________________ ______________________________    

__________________________________ ______________________________

_________________________________ ______________________________

PRODUCT: DISCOUNT: ___________________

TERMS: ______________________

QUANTITY: ___________________

NO CHARGE OFFSET PRODUCT: _________ ($__________) @ RETAIL VALUE.

SYSTEM: NET COST: _____________________

TERMS: ________________________

FREIGHT FOR PRODUCT AND SYSTEM: _______________________

SHIP DATE: (Pending credit approval): ___________________________

______________________ ___________________ _________________

Authorized Signature Title Date

Please complete and return to ______________________________ Sales Department

FAX # ____-____-_______

THIS ORDER WILL BE HELD UNTIL RECEIPT OF THIS SIGNED FORM.

Thank You.

Warning:
These forms are provided AS IS.  They may not be any good.  Even if they are good in one state or jurisdiction, they may not work in another.  And the facts of your situation may make these forms inappropriate for you.  They are for informational purposes only, and you should consult an attorney before using them.