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DIRECT PAYMENT INVOICE 

PLEASE SUBMIT MONTHLY 

n order to expedite payment for cellular telephone services and/or pagers not covered under the 
State of Alabama Contract, please complete this invoice. Please attach original copies of all 
charges. 

(Note: If your cellular or beeper services are contracted locally. 
we will continue to reimburse the County Commission. 

Please Print or Type 

I here certify that the following charges have been audited, personal use compensated, and are 
accurate  and  due  to  be  paid  for  the  period  ___________________________  through  
____________________________, 200________. 

 

 

 

_______________________________  
Signature  
_____________________________________________________________ 
Name & Address as it appears on Statement 
_____________________________________________________________ 
_____________________________________________________________ 
_____________________________________________________________ 
Telephone Number______________________________________________ 

_______________ 
Date 

 

lease Choose one: _______ Circuit Court     ____ District Court      ____ Clerk   _____ JPO    ______AOC 

ellular Telephone Services: 

Vendor __________________________________ 

agers: 

Vendor _______________________________________________ 

ccount Number __________________________ 

ccount Number _____________________________ 

          Total Amount on Statement   

              Less  Federal Tax Exemption 
Less Personal Use 
 
Less 911 Charges  
 
Less Service/Finance Charges 
 

 
 

 $ _______ 

-$_______ 
-$ _______ 
-$_______ 
-$_______ 

 

 Total 

 

$ ________

Total Amount on Statement      $ _______ 

      Less Federal Tax Exemption   -$_______ 
Less Service/Finance Charges  -$_______ 
 

 

 Total 

        $ ________

Submit Monthly to :  Administrative Office of Courts 
 
 
 

Finance Division / Expense Accounting Section 
300 Dexter Avenue 
Montgomery, AL   36104 

 
 
 

 
 
 

OC Use Only 

Vendor Code __________________________________ Accounting Code ______________________ 

Document ID __________________________________ 

Approved By:    

 

 

Date Approved: 

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