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GOLD LOAN SHOP

123, Main Street, City Name, State - 123456

Phone: 9876543210

Receipt No:3
Date:03-03-2026
Loan Amount:₹ 100,000.00
Customer ID:1
Name:sannasi
Mobile:9898987987979
Address:fdd, dfdg, fdghd, dfgd, dfgdg, sdg, 600000
Pledged Items
S.No Item Name Gross Wt (g) Deduction (g) Net Wt (g) Photo
1 ring 10.000 2.000 8.000
2 stud 1.000 0.000 1.000 -

Amount in Words: One Lakh Rupees

Interest Rate: 2.00% per month

Due Date: 03-03-2027



_________________________

Customer Signature



_________________________

Authorized Signatory

Subject to City Jurisdiction. Interest calculated monthly.

GOLD LOAN SHOP

123, Main Street, City Name, State - 123456

Phone: 9876543210

Receipt No: 3
Date: 03-03-2026
Amount: ₹ 100,000.00
Cust ID: 1
Name: sannasi
Mobile: 9898987987979
Item G.Wt N.Wt Photo
ring 10.000 8.000
stud 1.000 1.000 -

____________

Customer


____________

Signatory

GOLD LOAN SHOP

123, Main Street, City Name, State - 123456

Ph: 9876543210

Rcpt #: 3 Date: 03-03-2026

Name: sannasi

Mobile: 9898987987979

Address: fdd, dfdg, fdghd, dfgd, dfgdg, sdg, 600000...

Amount: ₹ 100,000.00

Interest: 2.00%

Words: One Lakh Rupees

Pledged Items
Item G.Wt N.Wt Photo
ring 10.000 8.000
stud 1.000 1.000 -

__________________

Customer Sig

__________________

Auth Signatory

GOLD LOAN SHOP
9876543210
Rcpt: #3 03-03-26
Cust: sannasi
Mob: 9898987987979
Item
GW
NW
ring
10.000
8.000
stud
1.000
1.000
Loan Amt: ₹ 100,000.00

Thank You!