Select payment type from options below:
Paper Check
Electronic Funds Transfer
Check Number:
Date:
*Must be after 1/1/2009		(MM/DD/YYYY)
Payment Amount:	$
		(Dollars and cents required)

Invoice Number:
Date:
		(MM/DD/YYYY)
Net Amount:	$
		(Dollars and cents required)
If your invoice contains a purchase order (PO), check the appropriate box below, else leave blank.
Material PO   Fuel PO