Republic of the Philippines }

_______________________ } s.s.

AFFIDAVIT OF CONSENT

I, _______________, Filipino, ____, _____ (__) years old, with address at

____________________________________, after having been duly sworn in accordance
with law, hereby depose and state, that:

1. I am one of the legitimate children of spouses _____ and ______;

2. ________________, of legal age, single, Filipino, with address at

_________________________, is my childless aunt, being the sister of my
father ___________;

3. My aunt ______________ desires to adopt me as her own child;

4. I have been living with my aunt _____________ since I was an infant, and my
aunt __________ has since then treated me like her own son and has
continuously reared and cared for me;

5. Because of this, my aunt ___________ developed a kind of maternal love for

me as her own child, exercising the care, concern, responsibility and diligence
of a good parent. I have also developed a kind of love or affection towards my
aunt, treating and considering her as my own mother;

6. By reason of this and throughout the years, I refer to my aunt _________ as

“mommy”;

7. I am not insane and I understand and have full knowledge of the intention of
my aunt _____________ to adopt me as her own child;

8. After being informed and explained of my adoption by my aunt

____________, I voluntarily and freely give my consent and approval to my
adoption by my aunt __________.

9. This affidavit of consent is executed for the purpose of attesting to the

foregoing.

IN TESTIMONY WHEREOF, I have hereunto set my hand this ____________ day

of _________________________ at ___________________________, Philippines.

__________________________________
NAME

The foregoing statements were explained to me and I sign the same with the
assistance of the Notary Public.

SUBSCRIBED AND SWORN to before me this _____ day of

_____________________ at ______________________, Philippines, affiant exhibiting to
me his competent evidence of identity, his ________________________________ issued at
_______________________ on _________________________.

NOTARY PUBLIC

Doc No. ________;

Page No. _______;
Book No. _______;
Series of 2009.