RENT RECEIPT Date  
No. 
Received from The Sum of  
Dollars 
For Rent at Paid by ☐ Check No. ☐ Cash 
For the Period to ☐ Money Order Received by  
Address 
Phone Landlord’s Signature	

RENT RECEIPT Date  
No. 
Received from The Sum of  
Dollars 
For Rent at Paid by ☐ Check No. ☐ Cash 
For the Period to ☐ Money Order Received by  
Address 
Phone Landlord’s Signature	

RENT RECEIPT Date  
No. 
Received from The Sum of  
Dollars 
For Rent at Paid by ☐ Check No. ☐ Cash 
For the Period to ☐ Money Order Received by  
Address 
Phone Landlord’s Signature