Form FMS-103-F5 Exhibit I "Pending/Missing Pc Alert Receipt Form" - Florida

What Is Form FMS-103-F5 Exhibit I?

This is a legal form that was released by the Florida Department of Juvenile Justice - a government authority operating within Florida. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on March 3, 2009;
  • The latest edition provided by the Florida Department of Juvenile Justice;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form FMS-103-F5 Exhibit I by clicking the link below or browse more documents and templates provided by the Florida Department of Juvenile Justice.

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Download Form FMS-103-F5 Exhibit I "Pending/Missing Pc Alert Receipt Form" - Florida

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DEPARTMENT OF JUVENILE JUSTICE
FINANCE & ACCOUNTING
PENDING/
MISSING PC ALERT RECEIPT FORM
CARDHOLDER NAME: ________________________________________________________
ORDER DATE: _______________________________________________________________
VENDOR NAME: _____________________________________________________________
PURCHASE AMOUNT: ________________________________________________________
DESCRIPTION OF PURCHASE: _________________________________________________
QUANTITY ORDERED: ________________________________________________________
DO/MA
NUMBER: ____________________________________________________________
SHIPPING AND HANDLING CHARGES, IF ANY: ____________________________________
OTHER CHARGES, IF ANY DESCRIBE: ___________________________________________
____________________________________________________________________________
Cross Reference Invoice#
______________________________________________________
RECEIPT WAS (check one): _________ LOST _________ NOT OBTAINABLE
I CERTIFY THAT THE ABOVE PURCHASE WAS MADE FOR OFFICIAL STATE BUSINESS.
______________________________________ __________________________________
CARDHOLDER SIGNATURE
SUPERVISOR SIGNATURE
______________________________________ _________________________________
DATE
DATE
PCARD STAMP HERE:
Revised 3/3/2009
DJJ-Purchasing Card
Pending/Missing PC Receipt Form
Exhibit I
Reset/Clear Form
Save As
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DEPARTMENT OF JUVENILE JUSTICE
FINANCE & ACCOUNTING
PENDING/
MISSING PC ALERT RECEIPT FORM
CARDHOLDER NAME: ________________________________________________________
ORDER DATE: _______________________________________________________________
VENDOR NAME: _____________________________________________________________
PURCHASE AMOUNT: ________________________________________________________
DESCRIPTION OF PURCHASE: _________________________________________________
QUANTITY ORDERED: ________________________________________________________
DO/MA
NUMBER: ____________________________________________________________
SHIPPING AND HANDLING CHARGES, IF ANY: ____________________________________
OTHER CHARGES, IF ANY DESCRIBE: ___________________________________________
____________________________________________________________________________
Cross Reference Invoice#
______________________________________________________
RECEIPT WAS (check one): _________ LOST _________ NOT OBTAINABLE
I CERTIFY THAT THE ABOVE PURCHASE WAS MADE FOR OFFICIAL STATE BUSINESS.
______________________________________ __________________________________
CARDHOLDER SIGNATURE
SUPERVISOR SIGNATURE
______________________________________ _________________________________
DATE
DATE
PCARD STAMP HERE:
Revised 3/3/2009
DJJ-Purchasing Card
Pending/Missing PC Receipt Form
Exhibit I
Reset/Clear Form
Save As
Print Page