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2. Blue Book Order Adjustment Form
   This form is for County of Lancaster Departments and Co-op Members to be used for errors on BLUE BOOK orders only. SUBMIT A NEW FORM FOR EACH ITEM.
4. Date*
   Date
6. Department or Co-op Name*
7. Contact Person*
9. Contact eMail Address:*
10. Contact Phone Number:*
12. Item Description*
13. Blue Book Catalog Number *
    INV- ###
15. Quantity Ordered*
16. Quantity To Be Adjusted*
17. Total Cost Of Adjusted Items:*
19. Reason For Adjustment*
    -- Select One --1 - Ordered Wrong Item2 - Wrong Item Received3 - Item Defective4 - Incorrect Quantity Received5 - Other (Please Explain Below)
21. Additional Information:
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit

* indicates a required field