Receipt of House Rent Payment

Received a Sum of Rs.__________ (Rupees )

from Mr/.Ms/.Smt. ________________________________towards the rent @ Rs. ______________

per month from ____ ________________to _______ _______in

respect of House situated at

_______________________________________________________________________________

(Affix Revenue Stamp of Re.1/-)

Signature of the House Owner

Date:

Name of the House Owner:

Address:
-------------------------------
-------------------------------
-------------------------------
PAN: -------------------------
Copy of the PAN of the house owner is mandatory if rent exceeds Rs. 1,00,000/- per annum .

Employee Signature & Date: