FORMAT TO BE USED FOR CONSOLIDATED RENT PAID FOR A SPECIFIED PERIOD

CONSOLIDATED RENT RECEIPT

Land Lord PAN:
Note:-This is to bring to your notice that the CBDT vide Circular No 8/2013 dated 10/10/2013 has made it mandatory
for the employees, claiming exemption in respect of House Rent Allowance, to report PAN of the landlord to
employer in case rent payment to the landlord exceeds Rs. 8,333/- pm

Received Rs. (Rupees Only)

from Mr. ________________residing at

towards RENT for the period FROM ______ TO _____where rent per
month is Rs. ____
Date:
Place:
Land Lord Name:
Land Lord Address:

Landlord Signature