CAREGIVER ACKNOWLEDGMENT. To be completed and signed by the caregiver) Ekri non ak adrès moun k ap bay swen an.I, Jessica Jones , am at least 18 years of age and the above child(ren) will reside with me at 123 Main Street, Boston, MA 01234 .Mwen, , gen omwen 18 lane epiMoun k ap bay swen an konnen dokiman sa a ba li dwa pou pran desizyon sou lekòl ak swen sante pitit ou yo, lè pitit ou yo ap viv ak li. Li pa ka deside yon bagay li konnen ou pa t ap dakò. Si ou chanje oswa ou anile akò sa a, moun k ap bay swen an ap bay tout moun kopi.Timoun non li (yo) anwo a pral viv ak mwen . This document shall take effect when the child(ren) is/are residing with me. My attestation of the residence of the child(ren) shall be sufficient evidence of such and presentation of this signed document constitutes my attestation.Dokiman sa a ap pran efè lè timoun nan (yo) ap viv ak mwen. Atestasyon mwen pou rezidans timoun nan dwe sifi kòm prèv rezidans li epi depi mwen prezante dokiman sa a ak siyati yo ladan sa reprezante atestasyon mwen.
