Scribd
Upload
28 views1 page

Receipt For Services

This document is a receipt for services template with fields for the faculty coordinator, location, date, payment amount and currency, recipient paid to, description of services provided, and required signatures of the recipient and faculty coordinator certifying that the items and totals listed are proper charges for services rendered.

Uploaded by

rajeshmanam
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
28 views1 page

Receipt For Services

This document is a receipt for services template with fields for the faculty coordinator, location, date, payment amount and currency, recipient paid to, description of services provided, and required signatures of the recipient and faculty coordinator certifying that the items and totals listed are proper charges for services rendered.

Uploaded by

rajeshmanam
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Receipt for Services Receipt for Services

Faculty Coordinator: ____________________________________ Faculty Coordinator: ____________________________________

Location: _____________________________________________ Location: _____________________________________________

Date: ________________________________________________ Date: ________________________________________________

Amount/currency of payment: _____________________________ Amount/currency of payment: _____________________________

Paid to: _______________________________________________ Paid to: _______________________________________________

For the following services: ________________________________ For the following services: ________________________________

______________________________________________________ ______________________________________________________

______________________________________________________ ______________________________________________________

______________________________________________________ ______________________________________________________

REQUIRED SIGNATURES REQUIRED SIGNATURES

Signature of recipient: Signature of recipient:

______________________________________________________ ______________________________________________________

Under penalty of perjury, I certify that for the purposes of Under penalty of perjury, I certify that for the purposes of
reimbursement, the items and totals listed herein are proper reimbursement, the items and totals listed herein are proper
charges for services rendered. charges for services rendered.

Signature of Faculty Coordinator: Signature of Faculty Coordinator:

__________________________________________________________ __________________________________________________________

You might also like