PAYEES RECEIPT

Received from the Director of State Lotteries,

Thiruvananthapuram a sum of Rs 6,16,00,000(Rupees Six Crore
Sixteen Lakhs only) after deducting income tax @ 30%Rs
2,64,00,000(Rupees Two Crore Sixty Four Lakhs only) from prize
amount of Rs 8,80,00,000(Rupees Eight Crore Eighty Lakhs
Only)and after deducting agent’s prize @12%, Rs 1,20,00,000
(Rupees One Crore Twenty Lakhs Only) from the prize amount of
Rs 10,00,00,000(Rupees Ten Crore Only) due to me against
Ticket No............................ which has won the......................prize
of the ...................................................draw of Kerala State
Lotteries held on ...........................

Signature on Revenue Stamp worth Re.1/-

Name & Full Address with PINCODE.

NB: Please refer the file number in all correspondence.