A bank or other financial institution uses this to acknowledge they have received a court order to deposit funds into a blocked account (form MC-355). WITNESS my hand and official seal. Signature. (Seal).A notary public or other officer completing this certificate verifies only the identity of the individual. Next, provide the name and signature of the person acknowledging receipt. (Name): We are acknowledging receipt of your application on (date of receipt). The sample acknowledgement letters for receipt of payment provided below can be used as format templates for official and personal purposes. California Free Receipt Template. If you need a written record of a transaction then use a receipt to outline the details of the purchase.