Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples). A form for the employee to sign acknowledging receipt of the policies.Following are samples of these provisions. The designated Dean(s) or Library Director will acknowledge receipt of the proposal and move it forward to the committee. Such a grievance must be submitted within five work days of the employee's receipt of the denial. Disclosure of Official Personnel Records. A copy of the reprimand will be provided to the employee and the signed copy acknowledging receipt will be placed in the employee's personnel file. INSTRUCTIONS: Fill out this Declaration completely and provide accurate information. Make at least one copy. The employee should write their total annual donation on the line provided.