Purchase Order Change Order Form - Excel

							                                                      Your Village


                          PURCHASE ORDER/TRAVEL AUTHORIZATION CHANGE FORM




      type of change form (check one):                purchase order                   travel authorization


  Vendor: Vendor Here                                                                                   Date:       01/05/06
             123 Expensive Street                                              PO/TA # to Change:                    16817
             Anchorage, AK 99507                                     Original Amount of PO/TA:                      $5,663.00
                                                                                  Corrected Amount:                 $6,031.98
       Phone #:
         fax # :


    Explanation:        $10.06 more for packing, & $328.92 more for postage.




                                                      Accounting Use Only

        Account Code:   01 4630.00 11/000 - $158.66

                        01 4630.00 21/000 - $210.32                                               OR No.

                                                                                              Vendor No.


                                                                                           Obligation No.   49305

                                                           Finance Director Approval




       Your Name                           1/5/06
Requested By                                   Date                         Authorized By                                      Date