On this ______day of ______, in the year 20____, before me,. Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples).Employees may have pay directly deposited into their bank accounts if they provide advance written authorization to Perry City. We are acknowledging receipt of your application on (date of receipt). The form should include the date, the payee of the check, the amount, the purpose, as well as a place for the check number. A rent receipt is a form that helps landlords and tenants prove the tenant paid the rent and that the landlord received the payment. On this _____ day of ______, in the year 20__, before me,. , personally appeared. A receipt is a written acknowledgment or proof of a financial transaction that provides evidence of the exchange of goods, services, or money between parties. A Utah notary acknowledgment form is a legal document a notary public completes to authenticate an individual's signature.