Certificate.
I, _____________________________________________________, (title)
certify that I have explained the foregoing undertaking in the
_____________________ language to _______________________________
__________________________ and ________________________________
foster parent(s).
_________________________
District Probation and Social
Welfare Officer
_________________________________
Witness
_________________________
Address of District Probation
and Social Welfare Office
_________________________________
Address of witness
__________________________________
Date
_____
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