(seq. 65)

FORM AF-1005 250M (5).(A).2.43-11267
The Commonwealth of Massachusetts
STANDARD INVOICE

FOR USE IN
COMPTROLLER'S BUREAU

5 VENDOR

AGENCY OR INSTITUTION DEPARTMENT
LOCATION TO WHICH DELIVERED

Name
and
Address
of
Vendor

NOT TO VENDOR
Use separate Invoice for each separate Purchase Order or delivery on contract.
Mail original and three copies to the Agency, Institution or Department to which the
goods were shipped or services rendered.

Agency, Institution or
Dept. Voucher No.

Purchase Order No.

Requisition No.

Account Name

Account No.

Vendor's Invoice No.

Invoice Date

Terms