po change finalization request form

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					                                   PO CHANGE/FINALIZATION REQUEST FORM
Date:                         ___________________________                             ____________________________
                                                                                               Authorized Signature
To Buyer:                     ___________________________                             ____________________________
                                                                                                   Printed Name
From:                         ___________________________                             ____________________________
                                                                                                    Extension
Part I - Finalization of PO

                     PO Number(s): _______________________________________________________________
                                       (Purchase Order will be liquidated in its entirety. No further transaction will be allowed.)

Part II - Change Order Request
                       Schedule
                       Line No./




                                                              New Distribution          Original                                New
                                    Current Distribution                                             Increase     Decrease
                          No.




        PO Number                                           Chartfield Changes (If     Schedule                               Schedule
                                         Chartfield                                                   Amount      Amount
                                                                      any)              Amount                                 Amount




Comments: ______________________________________________________________________________________________________

				
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