ACKNOWLEDGMENT OF RECEIPT OF A SUM IN CASH
(date) ____________________________________________________________________________________.
I, the undersigned, acknowledge receipt of the sum of ___________________________ dollars ($__________), paid by ____________________________________________________________________ (name of depositor)
(address of depositor).
Where applicable, a receipt conforming to the Real Estate Brokerage Act (chapter C-73.1) and the regulations made thereunder will be issued to the depositor as soon as that sum is deposited into a trust account.
(certificate number of real estate broker)
(name and address of real estate broker)
______________________________________________________________
Signature of person authorized by real estate broker