RECEIPT OF HOUSE RENT

(Under Section 1 (13-A) of Income Tax Act )

Received a sum of Rs (in words) _____________

________________________________________________________________(In words)

from Mr/Mrs._________________________________________

Towards the rent Rs. ______________ per month.*

For the period from ________________ (Month and Year)To_________________(Month and Year)

in respect of House No____________________________

________

__________________________________________________________________________

*Signature of the House Owner

LandLord Name :

Address:

OWNER'S PAN No:

* Mandatory fields: (Applicable only if rent is more then Rs. 8334 PM)

Note: This is only a format of valid rent receipt