RECEIPT OF HOUSE RENT

(Under Section 10 (13-A) of Income Tax Act)

Received with thanks a sum of Rs. ________________ (Rupees________________
_______________________________________________________________________
_
From Mr./Ms./Smt. ___________________________________________Towards rent
@____________________

per

month

from

April

______________

to

March______________ in respect of House No.____________________________

_________________________________________________ situated at ____________
_______________________________________________________________________.
(Affix Revenue Stamp of Rs.1/-)

Date :
Name :
Address: _____________________________
_____________________________________
_____________________________________
PAN No : ____________________________

Signature of the House Owner