CLIENT NAME ORDER NUMBER
CLIENT PHONE ORDER RECEIVED BY
ORDER DATE & TIME DATE PROMISED DATE DELIVERED
V I N
ODOMETER READING MAKE & MODEL
LICENSE # & STATE MOTOR #
LUBRICATE CHANGE OIL TRANS
BATTERY FLAT REPAIR WASH
DIFF WIPERS POLISH
AMOUNT
$
$
$
$
$
$
LABOR TOTAL
$
PART NUMB ER QUANTITY PR ICE PER UNIT AMOUNT
$ $
$ $
$ $
$ $
$ $
$ $
PARTS TOTAL
$
WORK OR DER
COMPILED BY
SUBTOTAL $
enter tax rate TAX R ATE %
WORK AUTHORIZED BY TOTAL TAX $
AUTHORIZING
PARTY SIG NATUR E
enter other cost OTHER $
AUTHORIZATION
DATE
TOTAL $
PART NAME
e
I N V O I C E
LABOR DESCRIPTION
Company Name
123 Company Address Drive
Fourth Floor, Suite 412
Company City, NY 11101
321-654-9870
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