How To Prepare a CD-406 Invoice Receipt Certification Form

Updated07/11/05

Sample Attached

The Invoice Receipt Certification (form CD-406) is used to process payment for products or services obtained by Purchase Order (form CD-404) that are coded and classified as Recurrence Supplies type 43. The Invoice Receipt Certification form must be adjoined to the Purchase Order document to be processed for payment. The information required on the Invoice Receipt Certification form must coincide with the information on the purchase order document before payment can be made to a vendor. To minimize interest penalties and payment delays, the Certification and Purchase Order must be processed within five business days of receipt.

Block 1. Purchase Order Number: Enter the purchase order number shown in block 6 of the CD-404.

Block 2. Type of Shipment: Enter "C" for Complete if all items were received from the vendor. Enter a "P" for Partial if all items/services were NOT received from the vendor.

Block 3. Date Goods Received: Enter the date the items/services were received in the office.

Block 4. Date Invoice Received: Enter the date the invoice was received in the office.

Block 5. Date Accepted: Enter acceptance date; must be within 7 days of receipt date.

Block 6. Vendor Invoice Number: Enter the vendor's invoice number located on the invoice. If there is not an invoice number, enter the account number, and if there is neither, enter "NONE."

Block 7-20 are self explanatory. See Sample.

Block 22. Signature, date, and phone number of receiving officials are required.

Prepare a separate CD-406 for each invoice. Attach the invoice to the 406 and submit the completed form to:

Questions concerning status of payment should be directed to the Department of Interior, National Business Center, Denver, Colorado at (303) 969-7780.

For additional information contact:
ITA: Roxanna Allen (202) 482-8363
NBC: Debbie Maier (303) 969-7780 ext. 2552.