Receipt	
No. [101]	

	

[Payee Name]
[Street Address]
[City, ST  ZIP Code]	
[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Description	
Amount	

	

	
Subtotal	

	
Tax	

	
Total	

		Receipt	
No. [101]	

[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Amount	

	

Subtotal	

Tax	

Total	

	

Receipt	
No. [102]	

	

[Payee Name]
[Street Address]
[City, ST  ZIP Code]	
[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Description	
Amount	

	

	
Subtotal	

	
Tax	

	
Total	

		Receipt	
No. [102]	

[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Amount	

	

Subtotal	

Tax	

Total	

	

Receipt	
No. [103]	

	

[Payee Name]
[Street Address]
[City, ST  ZIP Code]	
[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Description	
Amount	

	

	
Subtotal	

	
Tax	

	
Total	

		Receipt	
No. [103]	

[Payer Name]
[Street Address]
[City, ST  ZIP Code]	

Date	
Amount	

	

Subtotal	

Tax	

Total