Date __________________________
|
Landlord |
Tenant |
| Address | Address |
| Name | Name |
| Phone | Phone |
|
Description of Property |
The Landlord acknowledges receipt of the sum of $_____________________ paid by the Tenant to be credited to the rent due on the property described above for the period of _____________________, 20_________.
| __________________________________
Signature of Landlord |
| By:__________________________________ Name of Landlor |
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