I certify the information on the Patient Information Form is true and correct to the best of my knowledge. Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples).Letters acknowledging receipt of Gov. Benjamin Franklin Perry's Letters to his wife. I am not required to fill out an official form. Please acknowledge receipt of this message. So far as internal evidence is concerned, Franklin could have written everything in the letter either in February or in April 1767. Transaction in this folio. You may attach a separate nomination form in case of change in nomination. If Franklin wrote such an acknowledgment, eithe no copy of that letter has survived.