Republic of the Philippines)

________________________

AFFIDAVIT OF CONSENT TO
ADOPTION BY THE ADOPTEE

I, ANGELO PAULO BANQUESIO, of legal age, Filipino, single, with

residence and postal address at ____________ after having been sworn to
in accordance with law hereby depose and state the following: THAT

1. I am ____ years old having been born on

_________________________ at ____________;

2. I know that the Petitioner MA. LOURDES D. BANQUESIO

is asking the Court to make an order to adopt me;

3. I AGREE to being adopted by the Petitioner-

4. I have been given a chance to get counsellling;

5. I understand the nature and effect of this Consent;

6. I have spoken to a DSWD personnel-______ who has

explained adoption to me and what it means for me to
execute this Affidavit of Consent;

7. I further AGREE and give my FULL CONSENT that my

name after the adoption will be ________________________;

8. I am executing the herein Affidavit of Consent knowingly,

freely and voluntarily and aware of all the contents and
implications of what I am herein signing AND to declare
and affirm the truth of the above.

IN WITNESS WHEREOF, I hereunto affix my signature this _______

of _______________________ at ____________________

ANGELO PAULO BANQUESIO

Affiant
ID No. ___________________

Signed in the presence of:

_______________________ __________________________

SUBSCRIBED AND SWORN to before me this _______________ at

_________________, Philippines affiant exhibited his identification card
shown above. FURTHER, the contents of this affidavit is fully understood
and had been explained fully to the herein affiant. The herein
subscribing officer is satisfied that the affiant voluntarily and freely
executed this document.
Doc No.
Page No.
Book No.
Series of 2019