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MEMORANDUM OF AGREEMENT
RECITALS

No party is signing this Agreement in exchange for giving up parental rights to the
child, or in exchange for receiving consent to the adoption from either parent. Each party
is entering into this Agreement with the intent to abide by its terms to the extent that this
serves the best interests of the Child.

AGREEMENT
I, ___________________________, Filipino citizen, at legal age of________,
married/single/widowed/ and presently residing at______________________________,
Philippines, having been duly sworn in accordance with law, hereby depose and state:

That I am the legitimate mother of _______________________________________who

was born on ____________________in_______________;

That I have allowed______________________, the mother of the said minor to have sole
parental custody of our son since his birth in_______;

That I was unable to provide full support for the said child and believing that it would be
for his own interest and benefit, I, hereby signify my written intent, freely and voluntarily
to have our son ____________________________be adopted;

That I also signify my written consent, freely, willingly and voluntarily to have our son
_________________________be legally adopted by the ___________________and
____________________;

We, the undersigned, after careful consideration, agree to receive into our family, a child
to be named ______________________________________ and agree to assume the full
responsibility for the care. We understand that this placement is made with the
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expectation of legal adoption after the agreement of both parties, if at that time both
parties mutually agree that this placement is in the best interests of the child and family.

ENFORCEMENT

If any action is required to enforce any provision of this Agreement, the prevailing
party shall be entitled to recover from the other party, in addition to costs and
disbursements, all reasonable attorney fees.

MISCELLANEOUS

This Agreement shall become binding upon the date signed by all parties. The
parties understand that they may make informal alterations to this Agreement by mutual
agreement, but that this Agreement cannot be modified except in writing by all parties. If
any part of this Agreement is found to be unenforceable, the remainder of the Agreement
shall remain in effect and shall remain binding on all parties.

IN WITNESS WHEREOF, we have hereunto set our hands this __________ at

____________, Philippines.

_________________ _________________

Affiant Affiant

Witnessed by:

__________________

__________________
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AFFIDAVIT OF INTENT AND CONSENT

I, ______________________ of legal age, single, Filipino citizen and a resident of

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

1. That I am the biological mother of ____________________________ who was born

on __________________ at _____________________.

2. That I have not, at any time abandoned said minor child.

3. That I was unable to support said child and that believing that it would be for
(his/her)own interest and benefit, we, hereby signify our written intent, freely and
voluntarily to have our(son/daughter) ____________be adopted.

4. That I also signify my written consent, freely, willingly and voluntarily to have my
(son/daughter) ____________ be legally adopted by ____________________and
__________________of House Number, Philippines in accordance with law.

5. That I am ready and willing, freely and voluntarily to abdicate my parental authority
over said child in favor of the ___________________and___________________, who
are ____and _____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. I voluntarily and freely give the custody and care of my child

______________________and _____________________who are the prospective
adopting parents while the adoption process is being worked out.
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7. That I execute this affidavit to declare my intention and consent to adopt my

(son/daughter) _______________ as well as to the truth of the foregoing facts.

IN WITNESS WHEREOF, we have hereunto set our hands this __________ at

____________, Philippines.

_________________ _________________

Affiant Affiant

Witnessed by:

__________________ __________________

SUBSCRIBED AND SWORN to before me this ________________ at

_______________, Philippines. Affiant exhibited to be her _______________ with ID
No. _________________ bearing her photograph and genuine signature as competent
proof of her identity.

Adoptive Parents:

______________________ ______________________