Certificate of Service. Additional resources include a directory of local self-help centers.Page 1, Line 9; fill in the Broward County Utility Connection Permit Number. Page 1, Line 23; fill in the date the bond becomes in force. INSTRUCTIONS: The purpose of this form is to verify the status of a person acting as parent pursuant to School Board. The affidavit typically includes detailed information about how and when the service was performed, the identity of the recipient, and other relevant details. Complete this affidavit and submit to the student's school. Only notarized forms will be accepted. 2. Save the file on your local computer. Do not complete the form in your web browser as information will not be saved.