1. Service Receipt Service Receipt Number: Date:
Service Provider: Service Recipient:
Description of Services:
Service Date: Service Location: Price Per Hour: OR Flat Rate: Total Hours: Total Cost:
Payment Type: Cash Check Card Money Order Check/Card No.:
Signature:
Service Receipt
Number:
Date:
Service Provider: Service Recipient:
Description of Services:
Service Date: Service Location: Price Per Hour: OR Flat Rate: Total Hours: Total Cost:
Payment Type: Cash Check Card Money Order Check/Card No.:
Signature: