Insert Customer Company Letter Head

Purchase Order

Company Name: ________P.O. Date: ________Payment Terms\n*DFS LEASE or LOAN\n(Circle choice)
P.O. Number: ________
If no P.O. number is specified, the date on the P.O. will be used as the P.O. number.
Dell Customer Number: ________
Bill to Name: Street Address: City, State Zip Attn: Phone #:Ship To Name: Street Address: City, State Zip Attn: Phone #:Email:
  • Customer agrees to finance the products(s) itemized on the quotation number(s) indicated below at the price(s) indicated, plus applicable taxes and shipping & handling charges, subject to the applicable Dell terms and conditions of sale located at http://www.dell.com/terms.
  • *Lease Terms are applicable to this purchase order and are subject to Credit Approval. Additional financial information in the form of financial statements from previous years may be required.
  • Please attach tax exempt letter/certificate if applicable.

QTY QUOTATION OR PART NUMBER DESCRIPTION UNIT PRICE TOTAL

SUBTOTAL

Additional Instructions: FEIN SALES TAX (IF APPLICABLE) Please include tax exempt certificate if sales tax exempt noting vendor as Dell Financial Services SHIPPING & HANDLING ENVIRONMENTAL FEE TOTAL

DFS LEASE TERMS - Circle Choices MONTHS: 12 18 24 30 36 48 60 other...... End of Lease Option: Fair Market Value $1.00 Buyout Loan Other

Signature (Authorized Buyer): ___ Date: ___

Print Name (Authorized Buyer): ___Title___