Basic Sample Service Invoice Template

(Revised: 04/2014)
DATE: August 1, 2014
BILL TO:
Department of Workforce Development
DVR CCP Un it
PO Box 7852
Madison, WI 53707-7852
SERVICE FOR: July 2014
INVOICE #: xxxxxx
FEIN: xxxxxxxxx
Purchase Order Consumer Service Number of
Number Name Description Units Rate Total
----- ----- ----- ----- ----- -----
Total Amount Due This Bi lling: $xxxxx
Please remit payment to:
Main County
1 Main Street
Madison, WI 53703
If you have any questions, please call xxxx at xxx-xxx-xxxx.
Main County
1 Main Street
Madison, WI 53703
This i s not a required form, but a sampl e
copy showing the elements required for
an invoice. I f ALL of the el ements are not
present it may delay your payment.
Telephone: 555-555-5555
FAX: 555-555-5555
Page 1/1
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