1) Original Purchase Order Number

2) Vendor Contact Information

3) Original date of purchase

4) Requisitioning Department

5) Ship to information

6) Insert order information, i.e., items that were to be received, as noted on purchase order.

7) Sign for partial shipments here.

8) Sign for completed shipments here.

9) For Purchasing use only

10) Signature of the Director of Purchasing

ADDITIONAL INFORMATION:

• Return Pink Copy to Purchasing Department.
  Retain the Green Copy for your departmental records.