Instacart Receipt Example

This is a sample Instacart receipt showing Costco Order Subtotal, Delivery Fee and 2 more items, with a total of $186.84. Use it as a reference for what a real Instacart receipt looks like — then make your own with your items, prices, date and store details.

What's on this receipt

ItemQtyPrice
Costco Order Subtotal1$142.60
Delivery Fee1$3.99
Service Fee1$14.26
Tip1$15.00
Total (incl. tax)$186.84

Make your own in under a minute

Makecepeit lets you customize every field — business name, address, items, quantities, prices, tax, payment method and date — with a live preview, then download as a PDF or high-resolution PNG. No design skills needed.

SALES RECEIPT

Instacart

1247 Maple Avenue

San Francisco, CA 94105

(217) 555-0148

06/15/2026 13:42 · Receipt #759296

Store # 100Reg 1
ItemQtyPriceTotal
Costco Order Subtotal1$142.60$142.60
Delivery Fee1$3.99$3.99
Service Fee1$14.26$14.26
Tip1$15.00$15.00
Subtotal$175.85
Sales Tax (6.25%)$10.99
TOTAL$186.84
Payment MethodCredit •••• 4821

Thank you for shopping with us!

759296