Certification of Translation - screener

TRANSLATION CERTIFICATION
Services
by the CDCMultilingual
delivered
translation
Thisis to certifythatthefollowing
true
ability,_a
and
teamas an attichmentto thisletleris to the bestof ourknowledge
Fisher'
to us by Holly
delivered
of the originaltext(source)
translation
andaccurate
Title of the document in English:
Screener
MEMEligibility
-

Filenameof sourcedocument:
surveyo
Baseline
213172-B- NCHHSTP-Translation-Hkh3-QDS
GertifiedTranslator / Approving Official:
Kukucka
Claudia
Date delivered: 0511412010
Source language:English
Target language: SPanish
O r d e r# : 2 1 3 1 7 2

aretrueandthat
madehereinof my ownknowledge
I herebydeclarethatall statements
to be true;andfurtherthat
andbeliefarebelieved
madeon information
allstatements
andthe like
thatwillfulfalsestatements
werernadewiththe knowledge
thesestatements
or both,underSection1001of Title18
by fineor imprisonment,
so madearepunishable
the
mayjeopardize
statements
false
code, andthatsuchwillful
of the United'states
attachedherein'
validityof the documents
servicesteamherebyagreesto keepthe contentsof this
ThecDC Multilingual
of thetranslating
to the ethicalandlegalstandards
according
confidential
translation
or
transfer,distribute,
evaluate,
Ciscuss,
rmentwithanyperson(s),or anyother
of the client,as
n the directrepresentative
lment.
no matterhowsmall,willmakethis
document,
Anychangesmadeto the delivered
voidfor all purposes.
certification
611412010

Translator
of Translation
Certificate
NewYorkUniversity
ATAAssociateMember229373
Services
CDCMultilingual
CDC/CoCHlS/NCHM/DHC

Date