Republic of the Philippines )

Province of Davao del Norte)

City of Panabo ) S.S.
x----------------------------------------x

AFFIDAVIT IN LIEU OF CERTIFICATE OF LEGAL

CAPACITY TO CONTRACT MARRIAGE FOR
AUSTRALIAN CITIZENS

Before me, personally appeared the undersigned who, being sworn, states:

1) My name is CAMERON LLOYD THOMSON, of legal age, and I am a citizen of

Australia;

2) I hold a Australian Passport number PA5825505, issued on April 3, 2017 issued at

Australia;

3) I am a legal resident of U 3709, 128 Charlotte Street, Brisbane City 4000;

4) My address while in the Philippines is Purok-3, Southern Davao, Panabo City;

5) I have been married 1 times previously. All previous marriages have been legally
terminated.

CAMERON LLOYD THOMSON

Signature

SUBSCRIBED AND SWORN to before me this ____________ in Panabo City,

Philippines.

Doc. No. _____;

Page No. _____;
Book No. _____;
Series of 2023.