Invoice # ___________________	Order Date _________________
	S   H   I   P      T   O
	Customer Purchase Order # ___________________________	Customer Account # _________________________	Estimated Ship Date ________________________
	Date Received by MSI _________________________	Prepaid _________________	Ship Method ________________________

	Quantity	Part #	Description	Unit Price	Total Price

	Machine Model	Machine Serial #	Type of Feeder
Special Instructions:					Subtotal
					Freight
					Handling
					Total