Date: _________________

TO: Tenant______________________________Unit Address________________________________

Received from __________________________ the sum of $_________________, which is rent for the period of ________________________ for the premises described above.

LANDLORD

_________________________________

Date: _________________

TO: Tenant______________________________Unit Address________________________________

Received from __________________________ the sum of $_________________, which is rent for the period of ________________________ for the premises described above.

LANDLORD

_________________________________

Date: _________________

TO: Tenant______________________________Unit Address________________________________

Received from __________________________ the sum of $_________________, which is rent for the period of ________________________ for the premises described above.

LANDLORD

_________________________________