Dana Moshe Delivery

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Company Name: _______________

CONSIGNMENT
Name: _______________
Street Address: _______________ INVOICE
City, State, Country: _______________
ZIP: _______________
Phone: _______________
E-mail: _______________

Invoice #: _______________ Date: _______________

Client / Customer
Name: _______________
Street Address: _______________
City, State: _______________
ZIP: _______________

Description Quantity $ / Unit Amount ($)

Comments or Special Instructions: Subtotal


__________________________________________ Discount
Tax
Payment is due within ____ days. TOTAL

Thank you for your business!

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