RENT RECEIPT

Received a sum of Rs. _________ P.M (in words_______________________________

_______________________________________________________________________)

from Mr./Ms/Mrs. _____________________________________________ towards rent

of the premises as mentioned in the below for the month of ______________________

(From _________________ To _________________ )

Address of the House Land Lord Address & PAN

for which Rent is paid

__________________________ __________________________

__________________________ __________________________

__________________________ __________________________

__________________________ __________________________

__________________________ __________________________

Revenue
stamp
__________________________

Signature of the Land Lord

(Revenue stamp mandatory,except for Bangalore / Karnataka state locations)

Land lord's PAN is mandatory (in case rent is greater than Rs.8333.33/- per month)
or Declaration form from the land lord is required incase PAN is unavailable - Sample Format attached