A rent receipt serves as the landlord’s acknowledgment of a rental payment made by a
tenant. This template form allows the landlord to specify the amount paid by the tenant
or lessee and the form of payment, such as cash, check or money order. The receipt
should be signed by the landlord and given to the tenant. Landlords can use this form
to help track and account for payments received and tenants can use this form as
documentation for payments made.
To: (street address, city, state, zip code),
Received from (Name of Lessee or Tenant) the sum of $___________, as rent for the
period of (date) to (date) for the premises described above.
Signature of Landlord_________________________________________
Printed Name of Landlord ______________________________________
Paid By: Cash Check Money Order