RECEIPT ON ACCOUNT OF A DEBT 

I ______________________, S/o________________________, R/o _______________________ on this ____ day of ____ have borrowed and received from Mr. ______________________________, S/o___________________________, R/o ___________________________ the sum of Rs.___________ repayable within _____ years with interest at @ __ % per annum. 

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

Witnesses: 

1. 

2.