2.  SELLER'S COPY OF ORDER

U.S GOVERNMENT

PURCHASE ORDER-INVOICE-VOUCHER

DATE OF ORDER

ORDER NO.

PRINT NAME AND ADDRESS OF SELLER (Numbers, Street, City, and State)*

P
A
Y
E
E

FURNISH SUPPLIES OR SERVICES TC (Name and address)*

 

 

 

SUPPLIES OR SERVICES

QUANTITY

UNIT PRICE

AMOUNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENCY NAME AND BILLING ADDRESS*

TOTAL

P
A
Y
O
R

DISCOUTN TERMS

………….%................ DAYS

 

DATE INVOICE RECEIVED

ORDERED BY (Signature and title)

PURPOSE AND ACCOUNTING DATA


PURCHASERTo sign below for over-the counter delivery of items

RECEIVED BY

TITLE

DATE

SELLERPlease read instructions on Copy 2

PAYMENT RECEIVED $............................

PAYMENT REQUESTED $.............................

NO FURTHER INVOICE NEED BE SUBMITTED

SELLER

DATE

 

 

BY……………………………………………………………………

 

(Signature)

 

INSTRUCTIONS TO SELLER

After satisfactory identification of the Government representative presenting this purchase order. verify the itemization, including quantity, unit price, amount, total and discount sections.

This form is so designed that Copy I may be used as a cash payment receipt or as your invoice by completing, as appropriate, either the Payment Received or Payment Request blocks and signing the Seller Section.

If you would rather submit your own invoice, DO NOT SIGN COPY I, but attach it unsigned to your invoice to expedite verification and processing for payment.

2. SELLER'S COPY OF ORDER

STANDARD FORM 44b (Rev. 10-83)
PRESCRIBED BY GSA.
far (48 CFR) 53.213(c)