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. As Exhibit 10, is in the form described in the Technical Provisions, conforms to the Work. Breakdown Structure required under Sections 2.1. "I am one of the heirs of Decedent and am listed in the Application;. 3. (§42(m)(1)(C)(ii)) Applications may qualify to receive up to 7 points. Improving Homeless Data Collection,. Proper Notice and Acknowledgement Form. Sample Employee Acknowledgment Form - Receipt of Policies.