RECEIPT
(SPECIFIC)
This receipt acknowledges full payment, and
unconditional release of the following items:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
We ______________________________________ (Name of
Payee) acknowledge the receipt/payment of ___________________________ (Amount)
($_________) from _______________________ (Name of Payer) fulfilling all of the
terms of the original agreement dated _______________________ (Date).
_____________________________ Date:
________________________
Signed
_____________________________ Date:
________________________
Signed
_____________________________ Date:
________________________
Witness
