Your First Name/Last Name
\nAddress
\nPostal code/ CITY
\nRecipient
\nAddress
\nPostal code/ City
\nDone at [your city], the [specify the date].
\n\n
Subject : Debt clearance receipt
\n\n
Dear Sir or Madam,
\nI, the undersigned [name, first name], born on [date of birth] at [place of birth], residing at [indicate your address] have received the sum of [sum in words] euros, i.e., [sum in numbers] euros, paid by [moyen de paiement], from [name, first name], born on [date of birth] at [place of birth] and residing at [indicate your address].
\nThis amount corresponds to the loan I gave him on [date], repaid in full to date.
\nThis receipt therefore cancels the previously established debt acknowledgment dated [date] at [place of signature].
\n\n
[date and signature]
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