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Free form template · Word

HR Policy Acknowledgement

The HR policy acknowledgement is a combined sign-off sheet where an employee confirms receipt and understanding of each individual HR policy, listed with its version number. It saves collecting a separate form for every policy and gives HR one place to see what each employee has acknowledged.

  • Editable Word (.docx)
  • Made for India
  • 11 fill-in fields highlighted
  • Free, no sign-up

Preview of the form

[Highlighted] = fill in
[Company Logo][Company Name]

HR POLICY ACKNOWLEDGEMENT

Employee Name:
[Employee Name]
Employee ID:
[Employee ID]
Designation:
[Designation]
Department:
[Department]
Date of Joining:
[Date of Joining]

I confirm that I have received, read and understood the following policies of [Company Name]:

S. No.PolicyVersion / DateAcknowledged (Tick)
1Leave and Holiday Policy[Version / Date][ ]
2Attendance and Working Hours Policy[Version / Date][ ]
3Code of Conduct[Version / Date][ ]
4Prevention of Sexual Harassment (POSH) Policy[Version / Date][ ]
5IT Acceptable Use Policy[Version / Date][ ]
6Data Privacy Policy[Version / Date][ ]
7Travel and Expense Policy[Version / Date][ ]
8Separation and Exit Policy[Version / Date][ ]

Declaration

I agree to comply with these policies as amended from time to time. I understand that revised versions will be communicated to me by email or on [Policy Portal], and that I may contact HR for clarification. I understand that non-compliance may lead to action under the company’s disciplinary procedure.

Employee
[Employee Name]
Date: [Date]
HR
[HR Name]
Date: [Date]

What this template includes

  • Table of policies with version and date
  • Tick box for each policy acknowledged
  • General declaration of understanding
  • Statement on future revisions
  • Signatures of employee and HR

When to use it

  • At joining, when several policies are shared together
  • After launching or revising one or more policies
  • During a compliance audit of policy communication
  • When moving policies onto an intranet

How to customise this template

  1. 1List only policies that exist in your company
  2. 2Fill version numbers accurately
  3. 3Add rows for state-specific or site policies
  4. 4Re-use it when any listed policy is revised

HR tips

  • Keep policy names identical to the documents
  • Do not ask employees to sign for policies they have not received
  • Re-issue the sheet after major revisions

This template is a starting point. Review it against applicable labour laws, state rules, your standing orders and company policies, and with a legal adviser where needed.

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Frequently asked questions

What HR policies should new employees acknowledge?+

Usually leave, attendance, code of conduct, POSH, IT acceptable use, data privacy, travel and expense, and separation policies.

Is one form enough for all policies?+

Yes, if each policy is listed separately with its version, as in this form.

Where should signed policy acknowledgements be kept?+

In the employee’s personnel file or HRMS, where they can be retrieved for audits.