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DATE: INVOICE NO:

CUSTOMER DETAILS
NAME: DELIVERED TO
ADD: CUSTOMER:
CELL: REC BY:
PHONE: SIGNATURE:
DATE:
VEHICLE INSURER
MODEL: PHONE:
COLOUR: FAX NO:
REG NO: CLAIM NO:
V.I.N: ASSESSOR:

QTY DESCRIPTION UNIT PRICE TOTAL


R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
R -
SUB TOTAL R -
PAYMENT DETAILS - CASH ON DELIVERY VAT
BANK DETAILS GRAND TOTAL R -
FOR OFFICE USE ONLY
BANK: ABSA
ACCOUNT HOLDER: EZEQUIAS PANEL BEATERS
ACCOUNT NO: 4082536176