Liquid Controls DMS Delivery - Manual (Page 40)

40
Cylinder Fill Ticket
08/08/05 12:40:22
xxxxxxxxxxxx
xxxxxxxxxxxxxxxx
xxxxxxxxxx
xxxxxxxxxx
DATE 08/08/05 12:42:36
xxxxxxxx.x
xxxxxxxx.x GALLONS
LPG 1
CYLINDERS xxxxx
$xxxxxx.xx
CYLINDERS xxxxx
$xxxxxx.xx
CYLINDERS xxxxx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
Liquid Controls, LLC
105 Albrecht Drive
Lake Bluff, IL 60044-2242
(800) 458-5262
A. B. Costello
123 Main Street
Anytown, USA 55555
DATE
ACCOUNT #
REFERENCE
DRIVER #
TRUCK UNIT ID
------------------------------------------
SALE #123456
COUNT: START 0.0 END
GROSS DELIVERY
XXXXX XXXXXXXXXXXXXXXXX
VOLUME CORRECTED TO 60.0 F
------------------------------------------
(Product description text)
TANK xxxxxxxxxx
UNIT CHARGE $XX.XXXX
TANK xxxxxxxxxx
UNIT CHARGE $XX.XXXX
TANK xxxxxxxxxx
UNIT CHARGE $XX.XXXX
CYLINDER SUBTOTAL
Tax rate 1:
Tax rate 2:
Tax rate 3:
Misc Tran 1:
------------------------------------------
TOTAL INCLUDING TAX
PREVIOUS BALANCE
TOTAL DUE
IF PAID BY mm/dd/yy
IF PAID BY mm/dd/yy
IF PAID BY mm/dd/yy
------------------------------------------
Footer text line 1
Footer text line 2
------------------------------------------
RECEIVED BY ______________________________
Tickets
08/08/05 12:40:22
xxxxxxxxxxxx
xxxxxxxxxxxxxxxx
xxxxxxxxxx
xxxxxxxxxx
DATE 08/08/05 12:42:36
xxxxxxxx.x
xxxxxxxx.x GALLONS
LPG 1
xxxxxxxxxxxxxxx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
$xxxxxx.xx
Liquid Controls, LLC
105 Albrecht Drive
Lake Bluff, IL 60044-2242
(800) 458-5262
A. B. Costello
123 Main Street
Anytown, USA 55555
DATE
ACCOUNT #
REFERENCE
DRIVER #
TRUCK UNIT ID
------------------------------------------
SALE #123456
COUNT: START 0.0 END
GROSS DELIVERY
XXXXX XXXXXXXXXXXXXXXXX
VOLUME CORRECTED TO 60.0 F
------------------------------------------
TANK
(Product description text)
DROP OFF [email protected]
PICK UP [email protected]
CYLINDER SUBTOTAL
Tax rate 1:
Tax rate 2:
Tax rate 3:
Misc Tran 1:
------------------------------------------
TOTAL INCLUDING TAX
PREVIOUS BALANCE
TOTAL DUE
IF PAID BY mm/dd/yy
IF PAID BY mm/dd/yy
IF PAID BY mm/dd/yy
------------------------------------------
Footer text line 1
Footer text line 2
------------------------------------------
RECEIVED BY ______________________________
Cylinder Exchange Ticket