RECEIPT OF HOUSE RENT

Under Section 1(13- A) of Income Tax Act

Received a Sum of Rs.10000 (Rupees_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _) towards House Rent @Rs. (Rs_________________________)

per month from to from

Sri/ Sm t in respect of House NO.

situated at

(Affix Revenue St amp of Rs.1/ -)

Signat ure of the House Owner

Date:
Name:
Address:

PAN No:

Note:
1. PAN of Owner not mandatory
2. Revenue stamp necessary for Transaction more than Rs.5000/ -.