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Download-Order-Receipt-Form

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					Order Receipt Form
Name of the Vendor: --------------------------------------

Name of the concerned organization: --------------------------------------

Complete address of the vendor: --------------------------------------

City: --------------------------------------

State: --------------------------------------

Pin Code: --------------------------------------

Email id: --------------------------------------

Contact number: --------------------------------------

Size of the order: --------------------------------------

Quantity of the order: --------------------------------------

Amount/ Value of the order: --------------------------------------

Receiving Date: --------------------------------------

Method of Purchase: --------------------------------------

Mode of Payment: --------------------------------------Cash/Cheque/DD/Credit Card

Details of the Bank from where the transaction will happen: --------------------------------------

Name of the card holder (if the payment is made by a credit card): ------------------------------------

Card acct Number (last digits only): --------------------------------------

This receipt must be retained as a permanent record and it must appear as statement while monthly
transaction.

I hereby declare that the order is received and it is in the intact form as per the agreement.

Signature of the authority: --------------------------------------

Date: --------------------------------------
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