specific needs of children and elderly left behind as a ... - IOM Moldova

Annexes
Annex 8. Certificate for the registration of children who remain
in the country but whose parents/guardians, citizens of the
Republic of Moldova, are temporarily employed abroad
Heading of Social Work and Family Protection Department/
Child Protection Department from the municipality of Chisinau
ECPAMS-2
CERTIFICATE
for the registration of children who remain in the country but whose parents/
guardian, citizens of the Republic of Moldova, are temporarily employed abroad
issued to the citizen _______________________________________________________
(surname, name)
identity card ____________________________________________________________,
(serial number)
residence at _____________________________________________________________.
(locality, address)
The certificate confirms that, as a result of temporary employment abroad of the citizen:
_______________________________________________________________________,
( surname, name)
child __________________________________________________________________
(surname, name)
born on ________________________________________________________________,
(date, month, year)
birth certificate __________________________________________________________,
(serial number)
Was applied the form of protection: __________________________________________,
(forms of protection: guardianship, professional parental assistance, placement in family-type
________________________________________________________________________
care, any type of residential institutions, other legal forms of protection)
for a term of ____________________________________________________________.
Guardian of child is appointed ______________________________________________,
(surname, name)
identity card ____________________________________________________________,
(serial number)
residence at ____________________________________________________________.
(locality, address)
Note:
In the case of referring the child to a residential institution, should be indicated the name
and surname of institution’s manager, institution’s name and its juridical address.
Applicant
Head specialist in Child Rights Protection
Head of Social Work and Family Protection Department/
Child Protection Department from the municipality of Chisinau
Authority seal
Date of issue ___ ___________ 200__
Signature_______
Signature_______
Signature_______
The certificate is valid for 3 months from when it was issued.
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