Settlement Report
Order Header
Company
*
Manitoba
To:
Company Name
Street Address
City
State
Zip Code
PO#
Settlement Date
-
Month
-
Day
Year
Date
Received Date
-
Month
-
Day
Year
Date
F.O.B.
Receiver #
Pay Date
Pay Method
FedEx
Wire Transfer
Regular Mail
ACH
Details
*
Description
Gross
Tare
Net
Price
Total
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Grand Total
Issued By:
*
AS
BKS
RS
SS
Settlement Notes:
INTERNAL NOTES - Do Not Add to the Settlement
Submit
Clear Form
Should be Empty: