Reddiyat Makbuzu Örneği

T.C.

……………………………..İcra Dairesi                                                              Örnek No : 39

……………………………… Mahkemesi                                                 CİLT   No:

                                                                                                          SIRA   No :

Dosya No                              :  ……………………………………..

Borçlunun adı, soyadı           :  ……………………………………………………………………………………….

Alacaklının adı, soyadı          :  ……………………………………………………………………………………….

R E D D İ Y A T   M A K B U Z U

            Yukarıda (*) …………………………………………………………………………………… liranın ……………………………………… kuruşun …………………………………. verilmesi lazımdır.

                                                                       ………/……./……..

                                                                                                              Mühür ve İmza

Mezkür parayı İcra veznesinden tamamen aldım.

                                                                                                           Alanın İsmi ve İmzası

İHTAR  : (*) Lira ve Kuruş yazı ile yazılacaktır.