Receipt Template

1. Receipt Information

Receipt Number: [#]

Date of Issue: [Date]

Payment Date: [Date of Payment]

Reference / Invoice #: [Related Invoice Number, if applicable]

2. Issued By (Seller / Service Provider)

Name / Company: [Your Name or Company Name]

Address: [Street, City, ZIP, Country]

Email: [Your Email Address]

Phone: [Your Phone Number]

3. Received From (Client / Payer)

Name / Company: [Client Name]

Address: [Client Address]

Email: [Client Email]

Phone: [Client Phone Number]

4. Payment Details

Subtotal: $__________________

Discount (if any): – $__________________

Tax: $__________________

Total Amount Paid: $__________________

5. Payment Method

☐ Bank Transfer
☐ Cash
☐ Credit/Debit Card
☐ PayPal
☐ Other: ___________________________

6. Notes

• This receipt confirms that payment has been received in full.

• No further amount is due unless otherwise stated.

• Thank you for your business!

7. Authorization

Issued by: ___________________________

Title: ___________________________

Signature (optional): ___________________________

Date: ___________________________