Service Entry Sheet

Your Details

Indicates a field is mandatory
Name:
Phone No.:
Email:

Claim Information

Indicates a field is mandatory
Amendment Claim:
Service Entry Sheet Number:
Reason for Amendment:
Vendor Name:
Invoice / Ref No.:			PO No.:
External Ref No.:
Period From:			Period To:
South32 Contact:
Vendor Contact:
Short Description:

Services Being Claimed

Indicates a field is mandatory

NOTE: All items being claimed on this form must be entered in a single currency denomination.
Please also ensure all currency input are entered manually as international decimal values. Do not copy & paste values into the fields.

Currency for all items:

Input the relevant data into the fields below, and press "Add" button to add the record.
Repeat this process as many times as necessary to claim all items.

PO Item No		Service Line Number
Quantity
Description
Unit of Measure
Price per unit (Tax Exclusive)
Tax Component	Tax Applicable Tax Free
Tax Rate (%):

Additional Details

This section is mandatory

Attachments

This section is mandatory

Add Attachment click to add attachments

Request Summary