Sample Policy Receipt Acknowledgment for Employees to Sign

Use a Policy Receipt Acknowledgment When Employees Get a New Policy

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Do you need an effective way to ask your employees to state and sign off on the fact that they have been made aware of and received a copy of a new or changed policy? You'll want to use a policy acknowledgment receipt. Here is a sample policy acknowledgment receipt that you can use when employees need to acknowledge their receipt and understanding of a policy.

The signed policy receipt acknowledgment form is an effective way to ensure, as an employer, that you have made an effort to make sure that employees are informed of new workplace policies and expectations. This signed form ensures that you have done the best you can to make your employees informed about the expectations that exist in your workplace.

Especially in situations that might eventually involve disciplinary action or other legal issues, you want to have solid documentation as proof that the employee knew the rules.

When to Use a Policy Receipt Acknowledgment

When an employee is new, and you need him or her to get up-to-speed on all of your organization's policies, you can use the employee handbook to share the policies. This sample receipt works for employees to acknowledge receipt of the handbook and thus, all of the policies that are found in the handbook.

This sample policy receipt acknowledgment is for occasions when you introduce a new policy or change an already existing policy and need employees to know. The employees are expected to file the new or changed policy with their existing handbook or other company papers. Most organizations have moved to online versions of both employee handbooks and policies.

As such, you may ask employees to sign a policy receipt acknowledgment online. Some Human Resources managers may prefer a paper version for the employee personnel file.

How to Ask Employees to Sign a Policy Acknowledgement Receipt

Most frequently supplied during an informational meeting or in-house training session, the policy receipt is filled out under the direction of HR staff at the end of the meeting. You also provide the opportunity for the employees to express any concerns that they may have with the new policy.

You have the chance to answer what may well be questions shared by many when you have scheduled employees for the training as a group. This may prompt additional questions from others.

Do not let the employees take the policy receipt with them when they leave the meeting. You will spend the next several months chasing down the employees who never turned in the receipt of policy acknowledgment.

By signing the acknowledgment, the employees affirm that you have communicated the contents of the policy and that they have the information that you wanted them to receive from your communication.

It is a core policy for a Human Resources department as it is used whenever a new policy is distributed, and employees are trained on it. Rather than creating a generic example of a policy receipt, you may substitute any policy for the one used in the example below.

Following is a sample policy example as it is used for employees to acknowledge their receipt of and understanding of the new dress code.

Sample Policy Receipt Acknowledgment for a New Dress Code Policy

In effect: (Date) until further notice

I have read and been informed about the content, requirements, and expectations of the dress code policy for employees at Your Company. I have received a copy of the policy and agree to abide by the policy guidelines as a condition of my employment and my continuing employment at Your Company.

I understand that if I have questions, at any time, regarding the dress code policy, I will consult with my immediate supervisor or my Human Resources staff members.

Please read the dress code policy carefully to ensure that you understand the policy before signing this document.

Employee Signature:

Employee Printed Name:

Receipt By:


Please note that the information provided, while authoritative, is not guaranteed for accuracy and legality. The site is read by a world-wide audience and ​employment laws and regulations vary from state to state and country to country. Please seek legal assistance, or assistance from State, Federal, or International governmental resources, to make certain your legal interpretation and decisions are correct for your location. This information is for guidance, ideas, and assistance.