Date

Bill to: Ship to:

STATE: ZIP: STATE: ZIP:
Invoice Item Quantity Price Total
-
-
-
-
-
-
-
-
-
-
-
-
-
$ -
PHONE:
INTERNAL BILLING #:
CUSTOMER ID:
DATE: P.O./ORDER #:
Total Amount of Credit
Description
CITY:
ADDRESS:
PHONE:
REASON FOR CREDIT:
ADDRESS:
CITY:
CREDIT MEMO
APPROVED BY:
TERMS:
DATE: