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REPUBLIC OF THE PHILIPPINES )

CITY OF DASMARINAS, CAVITE. . . . . . . ) S. S.

AFFIDAVIT OF CONSENT WITH WAIVER

WE, SPS. ROLANDO PERU DELA CRUZ & CHRISTINE ARTEZUELA, Filipinos,
both of legal age, and residents of Blk 28, Lot 0, Brgy. Sta. Fe, Dasmarias
City, Cavite, after being duly sworn to in accordance with law, depose and
state: That - -

1. That we are the biological parents of JANA MAE ARTEZUELA DELA


CRUZ who was born on December 10, 2003 in Dr. Jose Fabella Hospital, Sta.
Cruz, Manila and KEREN ARTEZUELA DELA CRUZ who was born on July 25, 2002
in Dasmarias, Cavite as evidence by thereto attached Certificate of Live
Birth made integral part thereof, respectively;

2. The our said children are intending to travel to Australia;

3. That we, as parents hereby give our full consent and conformity
to the said travel of our above-mentioned children to the said country.

4. That for the duration of their travel to Australia, the above


mentioned children will be under our responsibility and we attest that they
will not be a charge to the Philippine Government or the Australian
Government in case of whatever happens to them.

6. We are executing this affidavit to attest to the truth and veracity


of the foregoing and for whatever legal purpose the same may serve;

IN WITNESS WHEREOF, we have hereunto affixed our signature this 5th


day of September 2016 in Dasmarias, Cavite.

ROLANDO PERU DELA CRUZ CHRISTINE ARTEZUELA


Affiant Affiant
PRO DL #N04-93-256684 Passport No. EC7284073
expiring on 3/27/18 02 APRIL 2016/DFA NCR EAST

SUBSCRIBED AND SWORN to before me this 5th day of September 2016


in Dasmarias, Cavite affiant exhibiting to me their competent identification
cards above.

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2016.