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Name of the company: Address of the company: I, _____ hereby declare that the amount received from ______ (Name of the buyer), the sum of Rs._______ […]

I,_______ the undersigned approved the accounts dated______ and hereby acknowledge to have received from_____ the personal representative of the above named deceased the sum of ________ […]

Date:                                                                      Receipt number: Amount received from: Address: Amount: Purpose of payment: ACCOUNT                                                    Payment Made By Total Amount: Cash: Amount Paid Cheque: Balance Due Others: Amount received […]