Receipt of certificate 2026

1. Click ‘Get Form’ to open the receipt of certificate in the editor.
2. Begin by entering your name in the 'Employee Name' field. Ensure that it matches your official identification.
3. Next, input your Social Security or ID number in the designated field to verify your identity.
4. In the 'Employer' section, confirm that 'State of Indiana' is displayed correctly as your employer.
5. Review the checklist provided and ensure all items are acknowledged. This includes understanding safety-sensitive functions and prohibited conduct.
6. Sign the document in the 'Employee Signature' field to confirm receipt of materials and understanding of policies.
7. Have an authorized employer representative sign in their designated area to validate the document.
8. Finally, enter the date on which you are completing this form for accurate record-keeping.

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