Learn what an acknowledgement receipt is and how to create one for your business (with a template and two examples). Wayne County Service Assistant.Ask a question or tell the service assistant what you need! This document is a receipt acknowledging payment received from an individual or entity. DEPARTMENT NAME: PAY-IN TOTAL: ACCOUNT NUMBER. For ideas to help you out in preparing your receipts, you can check out Printable Cash Receipt Templates available online. Next, provide the name and signature of the person acknowledging receipt. I understand that this payment is for services. Your Wayne State University eBill statement is available for student viewing and download in your Student Account Dashboard, accessible via Academica. City Clerk staff will contact applicants once payment can be accepted.