REPUBLIC OF THE PHILIPPINES )

CITY OF TAGUIG
)SS.

AFFIDAVIT OF INTENT AND CONSENT

I, MINDA GARMIN ROBLES Filipino, of legal age,

married and presently residing at Chico St., New
Lower Bicutan, Taguig City, having been duly sworn
in accordance with law, hereby depose and state:
1. That I am the legitimate parent of DIANA
GARMIN ROBLES, who was born on October 12, 2015 in
Doctors Hospital, Taguig City, Philippines.
2. That I have
said minor child.

not,

at

any

time

abandoned

3. That I am unable to adequately support

said child and that believing that it would be for
her own interest and benefit, I freely and
voluntarily consent to have my daughter adopted
legally.
4. That
I
also
freely,
willingly
and
voluntarily consent
to have
my
daughter
DIANA
GARMIN ROBLES legally adopted by the spouses DIEGO
A. LEGINO and SUSAN M. LEGINO who are residents of
Block 3, West Rembo, Makati City, Philippines.
5. That I am ready and willing to abdicate my
parental authority over said child in favor of the
spouses DIEGO A. LEGINO and SUSAN M. LEGINO, who
are 41 years old and 43 years old, respectively,
and who are both possessed of the necessary civil
and legal rights, who have good moral character,
and
who
have
the
financial,
emotional
and
psychological capacity to raise, rear and support
said child after adoption proceedings have been
instituted and even after a decree of adoption has
been issued.
6. I
execute
this affidavit to declare
my
intention
and
consent to the
adoption
of
my
daughter DIANA GARMIN ROBLES as well as to the
truth of the foregoing facts.
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IN WITNESS WHEREOF, I have hereunto set my hand

this ____ day of_________________, 2016 at Taguig
City, Philippines.

MINDA GARMIN ROBLES

Affiant

SUBSCRIBED AND SWORN TO before me in Taguig

City,
Metro
Manila,
this
_____
day
of
____________________,
2016,
affiant
having
exhibited to me her Police Clearance Certificate
issued by the Philippine National Police, Taguig
Police Station, on September 9, 2016, bearing both
her photograph and signature.

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