350x 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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