™Rent Receipt

Date: _________________

To: Address:

Received from _________________ the sum of $_______, as rent for the period of __________________ for the premises described above.

Landlord / Agent: __________________________________

Balance Due: $____________________

™

Rent Receipt Date: _________________

To: Address:

Received from _________________ the sum of $_______________________ for the premises described above

Landlord / Agent: _______________________________

Balance Due: $____________________

™

Rent Receipt Date: _________________

To: Address:

Received from _________________ the sum of $_______________________ for the premises described above

Landlord / Agent: _______________________________

Balance Due: $_____________

Paid By: Cash Check Money Order (Circle one)

__, as rent for the period of .

___

__.

_

Paid By: Cash Check Money Order (Circle one)

, as rent for the period of

__

Paid By: Cash Check Money Order (Circle one)

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