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CHILD CARE
AND PROTECTION
State name of applicant and if he is the superintendent also of the
approved school.
State person to whom contributions are payable under section 31
(2)
and
(3)
of
the
Child Care and Protection Act.
State place.
State name of parish.
Signature of the proper officer of the court.
[The inclusion of this page
is
authorized
by
L.N.
11
112005j