186x Filetype DOCX File size 0.04 MB Source: providers.dffh.vic.gov.au
ACME Disability Support Services Inc 123 Smith Street SMITHVILLE VIC 3333 Ph: 03 3333 3333 ACME TAX Fax: 03 2222 2222 Invoice queries: 03 3333 1111 Date: 1/03/2011 INVOICE Web: ww w .acmedss.o r g.au Account No: ABC1234 ABN: 21 123 123 123 Invoice Number: 155230 Client: Citizen, John Invoice to: Mr John Citizen 55 Station Street West Sunburn VIC 3310 Date Description Qty Rate Amount GST Total (inc GST) 09/05/2010 Personal Support 2.75 35.06 96.42 0.00 96.42 11/05/2010 Personal Support 0.75 35.06 26.30 0.00 26.30 22/05/2010 Personal Support 0.25 35.06 8.77 0.00 8.77 30/06/2010 Personal Support 2.00 35.06 70.12 0.00 70.12 01/07/2010 Personal Support 1.00 36.16 36.16 0.00 36.16 02/07/2010 Personal Support 3.00 36.16 108.48 0.00 108.48 08/07/2010 Community Support 4.00 36.16 144.64 0.00 144.64 02/07/2010 Transport 25 1 25.00 2.50 27.50 02/07/2010 Social Support 2 35.00 70.00 7.00 77.48 Total Grand Total (inc GST) 40.75 - 585.89 9.50 595.39 Please detach and return with payment PLEASE PAY INVOICE WITHIN 14 DAYS Account No: ABC1234 Invoice Number: 155230 Amount: $595.39 Please charge my Visa Mastercard Direct Deposit to CBA, Smithville Name on card: BSB: 000 111 Acc No: 125 789 Please fax remittance advice to: Finance Department 03 2222 2222 Expiry Date: / Amount $ or email to: finance@acmedss.org.au Signature:
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