Rent Receipts

Received with thanks from Mr./Mrs. _____________________________________________ a total sum of

Rs. ________________(in words __________________________________________________________) by

cash/cheque No. __________________ dated _______________ towards rent for the period from date:

______________ to date: _________________ against premises at ________________________________

________________________ City: ______________ State: _________________ Pin Code: ____________

Revenue
Stamp here

Name of Landlord:
___________________________ Signature of landlord (Cross Signature required)

Full Address of the Land lord: ________________________________________________________________________

City: ______________ State: _________________ Pin Code: __________

Date: Place: