ACKNOWLEDGEMENT RECEIPT
A receipt issued to confirm that specified documents, goods or items have been received from the named person on the stated date.
Ref. No.: [Reference Number] Date: [DD/MM/YYYY]
This is to acknowledge that we/I, [Name of Recipient], have received from [Name of Sender / Deliverer], residing/situated at [Address], the following [Documents / Goods / Items]:
1. [Description of Item] - Quantity [Qty]
2. [Description of Item] - Quantity [Qty]
3. [Description of Item] - Quantity [Qty]
The above have been received in [good / stated] condition for the purpose of [Purpose / Reference]. This acknowledgement is issued without prejudice and does not by itself certify verification of the contents.
[Signature of Recipient]
[Name & Designation]
[Firm / Department Name]
Place: [Place] Date: [DD/MM/YYYY]
How to use: List each item with its quantity, note the condition on receipt, and sign. Retain a copy for your records and hand the signed original to the sender.