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1. Party Information: Identification of the organization issuing the policy and the individual acknowledging it
2. Policy Identification: Clear listing of the specific policies being acknowledged, including their titles and version numbers
3. Acknowledgment Statement: Formal statement confirming that the individual has received, read, and understood the policies
4. Compliance Commitment: Statement of commitment to comply with the policies and understanding of consequences for non-compliance
5. Signature Block: Space for date, printed name, and signature of the acknowledging party
1. Training Confirmation: Section confirming completion of any required training related to the policies (include when policies require specific training)
2. Previous Versions: Reference to any previous versions of policies being superseded (include when updating existing policies)
3. Specific Acknowledgments: Bullet-pointed list of specific key points requiring explicit acknowledgment (include for complex policies)
4. Confidentiality Statement: Additional confidentiality commitments (include when policies contain sensitive information)
5. Review Period: Statement indicating any grace period for review and return of the acknowledgment (include when there's a deadline for return)
1. Schedule A - Referenced Policies: Complete copies of all policies being acknowledged
2. Schedule B - Summary of Key Changes: If acknowledging updated policies, a summary of material changes from previous versions
3. Schedule C - Relevant Contacts: List of relevant contacts for policy questions or reporting violations
4. Schedule D - Glossary: Definitions of key terms used in the policies (if not already included in the main policies)
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