Notice and Acknowledgment of Receipt-Civil. Notice and Acknowledgment of Receipt. (form. FL-117.) and a postage-paid return envelope addressed to me. Tell the court that the other party received a summons or other legal papers in a civil case that were delivered to (served on) that party. Complete and sign the sworn statement in item 4 in front of the notary public. Request the notary acknowledge your signature in the sworn statement in item 4. An acknowledgment is one of the most common types of notarial acts, but it often confuses Notaries. Here are 5 steps to performing an acknowledgment.