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Oath and Undertaking of PAPS

ICAB undertaking for complete and accurate

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UNDERTAKING AND OATH REGARDING
COMPLETE AND ACCURATE
INFORMATION ON PROSPECTIVE
ADOPTIVE PARENT/S AND ADOPTIVE
CHILD/REN

Issue
Date
Doc.
Code

March 6, 2018

Revision
No.

1

ICAB – RELAU–
F – 2013 – 004

I/We, ___________________________________, is/are applying to adopt the
child/ren, __________________________________ who was/were born on
_______________________ in the Philippines and is related/not related to us
by fourth (4th) degree of consanguinity.
Whereas, I/We understand that relative/non-relative adoptions of this type fall
under the rule of Inter-country Adoption Law Republic Act 8043 of the
Philippines;
Whereas, I/We understand that relative/non-relative adoption cases requires
special rules due to blood relation/circumstances of surrounding case of the
Prospective Adoptive Parents (PAPs) and the adoptee/s;
Whereas, I/We understand that it is necessary to ensure that complete and
accurate information is given regarding the PAP/s and the child/ren;
I/We therefore acknowledge each of the following to be true and accurate
statements, as verified by my/our initials and sworn signature:
1. All information I/We have provided about myself/ourselves, the adoptive
child/ren and the other family members of the adoptive child/ren (such
as birth certificates, marriage certificates, family trees, death certificates,
divorce decrees, verifications of addresses, employment or income, etc.)
are complete and accurate.
__________ (Initial)
__________ (Initial)
2. If there are multiple documents with different information about the
adoptive child/ren or his/her birth parents (such as birth certificates or
marriage licenses, etc.) I/We have provided true copies of each.
__________ (Initial)
__________ (Initial)
3. I/We have not made any other or previous pending effort(s) to bring the
above named prospective adoptive child/ren to the ____________
(country) (e.g through medical, tourist, student or relative visa).
__________ (Initial)
__________ (Initial)

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Inter-Country Adoption Board (ICAB)
UNDERTAKING AND OATH REGARDING
COMPLETE AND ACCURATE
INFORMATION ON PROSPECTIVE
ADOPTIVE PARENT/S AND ADOPTIVE
CHILD/REN

Issue
Date
Doc.
Code

March 6, 2018

Revision
No.

1

ICAB – RELAU–
F – 2013 – 004

4. I/We have not made any effort to adopt the child/ren within the Philippine
court system.
__________ (Initial)
__________ (Initial)

5. If I/We have in fact made an effort to adopt the child/ren within the
Philippine court system, I/We have filed a Motion to Withdraw that
petition and have provided a copy of that Motion, as well as all other
paperwork regarding that adoption petition, to my/our authorized foreign
adoption agency and/or Central Authority.
__________ (Initial)

__________ (Initial)

_____________________________
Name and Signature of the Male PAP
Date:

_______________________________
Name and Signature of the Female PAP
Date:

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪
Acknowledged before me this _____ day of ____________, 20___ in the
State/Province of ________________ Country of _______________.
Notary Public Name __________________ Notary Public
____________________
Notary Public Country of Residence ______________________
My Commission Expires _________________
My Public Seal

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Signature
 
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