The certificate of acknowledgment (PDF) must be in the form set forth in California Civil Code section 1189. Signature. (Seal). A notary public or other officer completing this certificate verifies only the identity of the individual.This form is used for acknowledging receipt of legal documents in California civil cases. Name: Signed: RESIDENTIAL SERVICES ACKNOWLEDGMENT RECEIPTS. I am here doing a um mock notarization for an acknowledgement and durat i want to show you how to fill out both of them. Next, provide the name and signature of the person acknowledging receipt. Fill out, sign, and affix your official seal to the Notary certificate. The wording requirements for acknowledgment certificates vary from state to state. (Signatures of two witnesses and their addresses). Notary Public. 6. 7.