________________________
________________________
________________________
________________________, ________________________ ________________________
RECEIPT
Date: ________________________
To:
________________________
________________________
________________________
________________________, ________________________ ________________________
Receipt number: ________________________
________________________acknowledges receipt from ________________________ of the sum of
________________________ paid by ________________________________________________. This
document acknowledges receipt of the following items, delivered by ________________________:
________________________
____________________________
________________________
________________________
____________________________
________________________
________________________
________________________