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UNIVERSITY OF LOUISVILLE
STOCKROOM REQUISITION

DO NOT ENTER MORE THAN 1 ITEM PER LINE.
DO NOT WRITE IN SHADED AREAS.
DO NOT RETURN ITEMS ON THIS FORM.

Effective July 13, 2005:  Lab Grade Alcohol orders cannot be submitted using this form. 
Click here to access the alcohol requisition form.

DATE ORDERED:

SPEEDTYPE:

ORDERED BY:

USERID:


DEPARTMENT:

BUILDING:

ROOM NO.

PHONE EXT.

APPROVED BY:


Quantity
Ordered
UnitDescriptionStock NumberQuantity ShippedAction


ACTION

1. Item temporarily out of stock. It will be held on backorder and delivered as
soon as received. If this is urgently needed please contact the buyer at
852-8216.
2. Item not carried in the Stockroom.
3. Stock numbers and description do not agree. Please check stock catalog
and reorder.
4. Partial shipment - Balance will be shipped as soon as received.


DATE ORDER FILLED: ____________________    NO. OF PKG SHIPPED: _______________

FILLED BY: ___________________    RECEIVED BY: ___________________________________________