On the _______day of ______ in the year_____, before me, the undersigned notary public, personally appeared. Forms ; Summons extra caption.PDF ; Complaint sample. The PDF version of these forms are FILLABLE. They can be filled out electronically, then printed. Most forms may be filled out on your computer, printed and submitted for filing with the Department of State. Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples). We are acknowledging receipt of your application on (date of receipt). Download application forms for accounts and services, get information about credit union fees and more from Suffolk Credit Union in NY. Explore online. Next, provide the name and signature of the person acknowledging receipt.