Write a consent script the person can understand

Answer in [ANSWER LANGUAGE], even if the material below is in another language.

I am about to record a testimony. Write the words I will say out loud to ask for consent, in plain language anyone can follow, including someone who cannot read. The recording will be [AUDIO OR VIDEO]. Ask me nothing about the person: this is a script I speak, not a record about anybody.

Rules:
1. Promise nothing I have not told you I can deliver. Where the script needs a fact only I know, leave a blank in square brackets with a short label, for example [WHERE THE FILE IS KEPT]. Never fill such a blank with a guess.
2. Never say the recording is safe, secure, anonymous, or impossible to trace. Say what happens to it, in plain words.
3. Short sentences. One idea per sentence. No legal wording and no form language.
4. Write it to be spoken, so I can read it aloud without stumbling.
5. Say clearly that the person may refuse, may stop at any moment, may answer some questions and not others, and that nothing they receive from us depends on their answer.

Give me, in this order:
A. The spoken script, covering in this order: what is being recorded and how long it will take, where the file is kept and for how long, who can listen to it, what will be published and where, what will be left out, how the person withdraws, who they contact to withdraw, and the last date on which withdrawal is still possible.
B. Three questions to ask afterwards to confirm the person understood, written so that yes or no is not an answer.
C. The one line to record at the start of the file to say consent was given, and the fields that line must contain.
D. Every square bracket blank you left, gathered in one list, so I can fill them in before I start.

Keep the whole page under 400 words.