Republic of the Philippines)

Province of Iloilo)S.S.
City/Municipality of Iloilo)
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JOINT AFFIDAVIT OF INTENT AND CONSENT
We Randy Spoelstra and Rebecca Spoelstra ,both Filipinos, of legal age, married and presently
residing at Bgy. Bantud, Jaro, Iloilo City, Philippines, having been duly sworn in accordance
with law, hereby depose and state:
1.That we are the legitimate parents of Remus Spoelstra who was born on March 18,
2016 in Jaro, Iloilo City, Philippines.
2. That we have not, at any time abandoned said minor child.
3.That we are unable to support said child and that believing that it would be for hisown
interest and benefit, we, hereby signify our written intent, freely and voluntarily to have
our son Remus Spoelstra be adopted.
4. That we also signify our written consent, freely, willingly and voluntarily to have our
son Remus Spoelstra be legally adopted by the spouses Simplicio Maravilla and Honesta
Maravilla of Jaro, Iloilo City, Philippines in accordance with law.
5. That we are ready and willing, freely and voluntarily to abdicate our parental authority
over said child in favor of the spouses Simplicio Maravilla and Honesta Maravilla, who
are 50and 49 years of age, respectively, and who are both possessed of the necessary civil
and legal rights as well as the financial capacity to raise, rear and support said child, after
the adoption proceeding had been instituted and an order of adoption be issued.
6. That we execute this affidavit to declare our intention and consent to the adoption of
our son Remus Spoelstra as well as to the truth of the foregoing facts.

IN WITNESS WHEREOF, we have hereunto set our hands this March 20, 2016 at Iloilo City,
Philippines.

Randy Spoelstra
Affiant

Rebecca Spoesltra
Affiant

SUBSCRIBED AND SWORN to before me, this March 20,2016, by Randy Spoesltra who
exhibited to me his Community Tax Certificate No.1122-1445-244 issued at Jaro, Iloilo City on
March 19,2016 and by Rebecca Spoelstra who exhibited to me her Community Tax Certificate
No. 1123-1335-255 issued at Jaro, Iloilo City on March 20,2016.

ATTY. JAGE JOSEPH M. SUROPIA

Notary Public

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