RECEIPT

Dear Felix

TO: [NAME OF PERSON MAKING PAYMENT]

RE: [BRIEFLY DESCRIBE TRANSACTION OR CIRCUMSTANCES GIVING RISE TO PAYMENT]

The undersigned hereby acknowledges receipt of payment of the sum of [AMOUNT OF PAYMENT RECEIVED, ex. $15,000.00)].

DATED: [DATE OF DOCUMENT, ex. July 1, 1998]

Regards
Lydia