University of Virginia -- Procurement Services
Purchase Order Change Request Form
(Not to be used with LPOs)
*
Required Field
For assistance with this form, contact our
Expeditor
.
PO to be corrected:
PO Number
*
Supplier Name/ID#
Change Requested:
Change Supplier ID # to
Change F.O.B. Terms to
Change Delivery Location Code to
Extend Delivery/Period of Performance Date to
All expected invoicing against this PO is complete -- please reduce to invoiced amount and close.
This is an unused PO, and there has been and will be zero invoicing against it -- please cancel the PO
Change PTAEO -- P
T
A
E
O
Add Lines
Change Lines
PO Line
Description
Quantity
Unit Price
Amount
Reason for Change
*
Check here if additional forms are attached.
Requestor Information:
Department Name
Prepared By
*
Date
Phone No.
*
Email:
Approved By
Date
Phone No.
Email: