NYSSS Payment invoice v2 updated 03 12 by QHRDSL7

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									INVOICE

Xxcpillar                                 Supplier details:
North Yorkshire and York PCT
5NV Payables 6675
Phoenix House
Topcliffe Lane
WAKEFIELD
WF3 1WE


Invoice No.                               VAT Registration No:


Invoice Date                              Period of claim
(Tax Point)
                                          From:

                                          To:



Nicotine Replacement Therapy

Part A
NRT items dispensed (total of column
A6 on payment claim summary)
Part B
Specialist Service NRT Access Scheme
Vouchers (total of column B6 on payment
claim summary)
Part C
Quitters (total of column C5 on payment
claim summary)

                SUB-TOTAL A + B + C

5% VAT
(total of columns A7 and B7 on payment
claim summary)


                      INVOICE TOTAL


NOTES:

   -   VAT MUST ONLY BE INCLUDED ON THE VAT LINE

   -   THE FINAL INVOICE TOTAL MUST AGREE WITH THE TOTAL PAYMENT
       CLAIM SUMMARY. ANY DISCREPANCY WILL RESULT IN A DELAY IN
       PAYMENT.

V2.Mar12/GB

								
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