OFFICIAL RECEIPT
LOGO, NAME AND ADDRESS OF THE PRACTICE OR: LOGO OF THE C.H.J.Q., NAME AND ADDRESS OF THE PRACTICE
OFFICIAL RECEIPT
No. __________
Received from ______________________________________________________________________________
the sum of _________________________________________________________________________________
□ cash □ certified cheque □ non-certified cheque
□ postal money order □ bank draft □ other
□ down payment □ final payment
With respect to file ___________________________________________________________________________
□ sum of money collected on behalf of another party
□ sum of money recived as an advance
□ sum of money received as a guarantee when acting as a seizing officer
____________________________________________
Bailiff