Cheque Receipt Acknowledgement Letter. Door Number and Street's Name, Area Name, City.An acknowledgment is one of the most common types of notarial acts, but it often confuses Notaries. Here are 5 steps to performing an acknowledgment. Forms and policies for organizations and individuals making CORI requests can be found here. , check, credit card), and the payment amount. After the receipt expires, you should:. You can send a check with your completed form, payable to the Commonwealth of Massachusetts. A receipt showing that your employee has applied to replace a List A, B, or C document that was lost, stolen, or damaged. Here's some information on how to submit original claims to us.