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