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Sample receipt

Payment Receipt & Declaration upon termination of contract

I, Ms. ___________________, holder of HKID card no. ___________, had

received the following from my employer _______________(full name of

employer) on ______________(date).

Wages from ________ to ________ One Month Notice Statutory Holiday ( days) Annual Leave (pro-rata) Return airline ticket to ____________ Travelling allowances	HK$ HK$ HK$ HK$ HK$
___________________________________________________________
Total Amount	HK$

Remark:

I am leaving my employer's house under good physical, mental, and psychological condition.

Received and confirmed by: _______________ (Signature)

Date: _____________

_______________
(Domestic helper)

Acknowledge by: _______________ (Employer)

Date: _____________