Republic of the Philippines )

) S.S.

AFFIDAVIT OF INTENT AND CONSENT TO ADOPTION

I, XXXXXXXX, Filipino, of legal age, married and presently residing at XXXXXXXXXX,

Philippines, having been duly sworn in accordance with law, hereby depose and state:

1.That I am the illegitimate mother of XXXXXXXXXXX, publicly known as

KEXXXXXXXXX, who was born on XXXXXXXX.

2.That when my son, XXXXXXXXXXXX was still a minor, I had the sole parental custody
and authority over him.

3. That I had not, at any time abandoned my son XXXXXXX (Kent Rayner) when he was
still a minor.

4.That on 4 July 2002, I married XXXXXXXXXX in Abu Dhabi, United Arab Emirates.

5. That beginning when my son, XXXXXXX was only nine (9) years old until he reached
the age of majority, my husband XXXXXXX joined me in providing physical, moral, and
financial support to the former.

6. Believing that it would be for his own interest and benefit, I hereby signify my written
intent and consent, freely and voluntarily to have my illegitimate son, XXXXXXXXX be
legally adopted, in accordance with law, by my lawful husband, XXXXXXXX, who is 61
years of age, and who possesses the necessary civil and legal rights as well as the
financial capacity to continue rearing and supporting my son, after the adoption
proceeding had been instituted and an order of adoption be issued.

7. That I execute this affidavit to declare my intention and consent to the adoption of my
son XXXXXXX as well as to the truth of the foregoing facts.

IN WITNESS WHEREOF, I have hereunto set my hands this ____________________ at

______________________________________.

XXXXXXX
Affiant