Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples). What do you need to include in your donation acknowledgment letter?A form for the employee to sign acknowledging receipt of the policies. Following are samples of these provisions. Here is a sample policy acknowledgment receipt that you can use when employees need to acknowledge their receipt and understanding of a policy. Download a free Acknowledgement of Receipt form for the Violence in the Workplace Policy and Procedure in Florida. Notice and Acknowledgement of Pay Rate and Payday. Under Section 195.1 of the New York State Labor Law.