Sworn to (or affirmed) before me this _____ day of __________, (year) , by (name of person making statement) , and subscribed by (name of notary) at the direction of and in the presence of (name of
Gudoomiye Yariisow ayaa sheegay inaysan waxba iska badalin mowqifkiisii ahaa in la isaga guuro xerada Mariino ee ciidanka Badda Soomaaliya.