RENT RECEIPT
Date: _____________________ To: _______________________ Street Address: _______________________________________________________________ City: __________________________ State: ________ Zip Code: _______________________
This is to acknowledge that the undersigned has received the sum of $ ___________________ from ____________________. This amount constitutes [partial][full] payment for the period of __________ to _____________ for the above-described premises. [This leaves an outstanding balance of $_____________, which must be paid to the undersigned by the tenant no later than _______________________, ___________.]
Received by: _________________________________________ Printed Name: ________________________________________ Title: ________________________________________________ Paid by: Cash Personal Check (if selected, # ________________________) Cashier’s Check Money Order (if selected, # __________________________)
Rent Receipt