Free rent receipt 38
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First Month Rent, Last Month’s Rent or Security Deposit Receipt
(Attach copy to rental agreement)

Name of Renter(s)
Rental Property Address
Lease Period


To Be Completed by Landlord or Authorized Representative:
Funds totaling $___________________ were received by tenant(s) on the date identified below:
The funds for the above rental property are to be applied by the landlord, ____________________
as follows:
First Month’s Rent:
Last Month’s Rent:

$ _____________________
$ _____________________ (R.I. law prohibits landlords from collecting

Security Deposit:

$ _____________________

last month’s rent and security deposit)

Fee To Rental Agent: $ _____________________
Name of person receiving payment (if other than landlord) _______________________________

Signature (by hand) of Landlord or Authorized Representative

Date Signed