English to Polish Other Law (general) tenancy agreement for a h

Social work evidence template
The social work evidence template has been produced by ADCS and Cafcass. It can be used by local authorities to submit an application for a care or supervision order.
The template supports professionals in submitting summarised, clear and analytical material to the court, setting out the reasons why the local authority is making an application for a specific order in relation to a child. A balanced, analytical and evidence based application will avoid unnecessary delay for the child and enable the court to quickly identify the issues in dispute, and potentially limit the cross examination of evidence.
This template is not mandatory but is endorsed by:
the President of the Family Division
the Association of Directors of Children’s Services
Cafcass
Her Majesty’s Courts and Tribunal Service
Department for Education
Ministry of Justice.

I am trying to find an elegant way of saying this (it's a title of official document), but the only thing I came up with so far is

Wzorzec dla slużb socjalnych samorządów lokalnych wykazujący dowody.

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