RECEIPT BY AGENT 

I __________________________, S/o______________________, R/o ___________________________ on behalf of and as the agent of Sh. _______________________, S/o___________________________, R/o ______ have received on this ___ day of ____ from Sh. _____, S/o______, R/o _______ the sum of Rs. ______ on account of license fees for the period of ____ to _______ for Sh.._________________ the property situated at ________________________________

Signed by _____ on this ___ day of ____ in the presence of the following witnesses. 

(Signed) 

Agent for the said Sh.__ __________________________________________

Witnesses: 
1. 

2.