Common use of Expenses Necessary to Complete Your Adoption Clause in Contracts

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH CCAI App Submission First Program Fee (includes Home Study) $6,000 – Check/ACH CCAI After App Approval IAAME Monitoring & Oversight Fee (per child) $500 – Check/ACH CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 per adult for fingerprinting – Check/ Money Order USCIS When filing I600a with USCIS Dossier Preparation Approx. $350 – Check/ Money Order Secretary of State(s) As preparing Dossier Second Program Fee $3,650 – Check/ACH CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator used) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Deposit $200 – Check/ACH CCAI At time of invitation to travel to Ukraine US Domestic & International Airfare (3 trips) $1,300-$1,800 per adult/per trip (economy) + Approx. $1,000 child ticket (one-way) – Credit Card A travel agency/airline of your choice Approximately 10-14 days prior to departure In-Ukraine Travel & Meals/Accommodations (total for all 3 trips, estimated 25 days) $2,285 - $7,500 per couple adopting one child Apartment Rental/ Transportation/ Restaurants/Etc. In Ukraine Child Passport $100 - $150 Local Ukraine Agency In Ukraine Child Physical Exam $215 Embassy-Approved Doctor In Ukraine Ukraine Assistant (total for all 3 trips, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Child U.S. Entry Visa $325 – Cash U.S. Consulate Kiev, Ukraine In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Court Validation Fee Varies by state/county Your County Court After U.S. return State Birth Certificate Varies by state State Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption TOTAL ESTIMATE: $31,210 – $46,645 for a couple adopting one child (not including citizenship/validation deposit) * Please see Explanation of CCAI Service Fees for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institution.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine Latvia adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH Check CCAI App Submission First 1st Program Fee (includes Home Study) $6,000 – Check/ACH 5,000 Check CCAI After App AfterApp Approval IAAME Monitoring IAAMEMonitoring& Oversight Fee (per child) Fee# $500 – Check/ACH Check CCAI (forwarded to IAAMEtoIAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 85 per adult for fingerprinting in home – Check/ Check/Money Order Order/Credit Card USCIS When filing I600a with USCIS homestudy is completed Dossier Preparation Approx. $350 360 – Check/ Money Order Secretary of State(s) As preparing Dossier Second Home Studyfee As agreed with local homestudy agency Your home study agency As agreed with local homestudy agency In-Country Translation Fee $2,530 (wiring fee included) - Check CCAI (wired to Latvia) Dossier submission to CCAI 2nd Program Fee $3,650 4,650 – Check/ACH Check CCAI Dossier submission to CCAI RefundablePost Adoption Deposit $1,000 – Check CCAI At Referral Acceptance 1st trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus$1,000 per child one way ticket– Credit Card A travel agency of your choice Approximately 10- 14 days prior departure In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090CountryLegal Fee** (depending on facilitator used) – Check $2,730 (wiring fee included) – Check(for 1 child) CCAI (wired to UkraineLatvia) Dossier submission 2 weeks prior to CCAI First Trip Second Trip ( Courtfirst trip Latvian Apartment & Room & Board (approx. 19 to 26 days for first trip) Refundable Citizenship/ Validation Deposit Approx. $200 – Check/ACH CCAI At time of invitation to travel to Ukraine 100-$125 apartment per night. Ranges from $1900- $3,250 Cash. Food approx. $20-$45 a day per person - $420 - $945. Apartment Property Manager In Latvia Child US Visitor B2Travel Visa $190 - Cash U.S Consulate,Riga. Latvia In Riga, Latvia 2nd trip - US Domestic & International Airfare (3 trips) $1,300-$1,800 800 - $1,500 by coach per adult/per trip (economy) + Approxadult plus child, if child is 12 yrs. $1,000 child ticket (one-way) of age or older– Credit Card A travel agency/airline agency of your choice Approximately 10-10- 14 days prior to departure In-Ukraine Travel Latvian Hotel& Meals/Accommodations Room & Board (total for all 3 trips, estimated 25 days) $2,285 - $7,500 per couple adopting one child Apartment Rental/ Transportation/ Restaurants/Etcdaysfor second trip Approx. In Ukraine Child Passport $100 - $150 Local Ukraine Agency 200 for hotelper night.$300 - $600. Food approx.$20 - $45 a day per person- $140 -$315. Hotel Rental Service In Ukraine Child Physical Latvia 3rd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus 800-$1500 per child ticket– Credit Card A travel agency of your choice Approximately 10- 14 days prior to departure Latvian Apartment Room & Board (approx. 7-10 days for third trip) Approx. $100 - $125 per night for apartment $700 - $1250 – Cash.. Food approx. $20 - $45 a day per person* - $140 - $315 Apartment Property Manager In Latvia In-CountryLegal Fee** $2,530 (wiring fee included) – Check (for 1 child) CCAI (wired to Latvia) 1- 2 weeks before third trip US Embassy Medical Exam $215 Embassy-Approved Doctor 200 – Cash Clinic In Ukraine Ukraine Assistant (total for all 3 tripsRiga, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Latvia Child U.S. Entry Visa $325 – Cash Cash, submittedfirst trip U.S. Consulate KievConsulateRiga, Ukraine Latvia In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Riga, Latvia Post Placement/Post Adoption Services As agreed with local home study agency Your home study agency As agreed with local home study agency Court Validation Fee Varies by state/county Your County Court county court After U.S. return State 3rd U.S Return Child’s Birth Certificate Varies by state State Vital Statistics Office Your state After 3rd U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption Return TOTAL ESTIMATE: $31,210 – $46,645 29,350-$36,450 ( Not including home study or post adoption costs) **AdditionalInCountryLegal Fees will apply for a couple adopting one multiple placements. ***Post adoption reports are required by the Ministry until the child reaches 18 years of age (number of additional reports and associated fees to be determined after child referral) Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the Ministry of Welfare), non-CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not including citizenshiprefundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/validation deposit) * Please see Explanation Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of , this day of , 20 . My Commission Expires: / / . Notary’s Signature: Note: This three-page document is not valid unless all pages are initialed/signed and returned to CCAI. CCAI Latvia Service Agreement This CCAI Service Fees Agreement effective as of the date last signed (“Effective Date) is entered into between CCAI and and , a married couple [or a single woman], (hereafter collectively [individually] referred to as the “Adoptive Family” or “We” “you” “your” “our” “us” and, sometimes individually as “I” “my”) (the “Service Agreement”) for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionthe purpose of ensuring mutual understanding between CCAI (the “Primary Provider”) and the Adoptive Family.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine Latvia adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH Personal Check CCAI App Submission First Child Abuse Record Search $35/family – Check CO Department of Human Services App submission 1st Program Fee (includes Home Study) $6,000 – Check/ACH 6,300 Check CCAI After App Approval Colorado State Approval $250 – Check Lutheran Family Services via CCAI When Home Study is approved by CCAI IAAME Monitoring & Oversight Fee (per child) $500 – Check/ACH Check CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 85 per adult for fingerprinting in the home – Check/ Money Order Check/moneyorder USCIS When filing I600a with USCIS home study is completed Dossier Preparation Approx. $350 360 – Check/ Money Order Secretary of State(s) As preparing Dossier Second In-Country Translation Fee $2,530 – (wiring fee included) Check CCAI (wired to Latvia) Dossier submission to CCAI 2nd Program Fee $3,650 5,200– Check/ACH Check CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator usedCourt Validation Deposit(refundable) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Deposit $200 – Check/ACH Check CCAI At time acceptance of invitation to travel to Ukraine referral 1st trip - US Domestic & International Airfare (3 trips) $1,300-$1,800 800 - $1,500 by coach per adult/per trip (economy) + Approx. adult plus $1,000 for a child ticket (one-way) one way ticket– Credit Card A travel agency/airline agency of your choice Approximately 107-14 10 days prior to departure In-Ukraine Travel Country Fee** $2,530 (wiring fee included) – Check (for 1 child) CCAI (wired to Latvia) 2 weeks prior to first trip Latvian Apartment & Meals/Accommodations Room & Board (total approx. 19 to 26 days for all 3 trips, estimated 25 daysfirst trip) Approx. $2,285 100-$125 apartment per night. Ranges from $1900 -$3,250 – Cash. Food approx. $20 - $7,500 45 a day per couple adopting one person - $420 - $945 Apartment Property Manager In Latvia Child US Visitor B2 Travel Visa $190 - Cash U.S Consulate, Riga. Latvia In Riga, Latvia 2nd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus child, if child Apartment Rental/ Transportation/ Restaurants/Etcis 12 yrs. In Ukraine Child Passport of age or older– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Hotel& Room & Board (3 days for second trip) Approx. $100 - $150 Local Ukraine Agency 200 for hotel per night. $300 - $600. Food approx. $20 - $45 a day per person - $60 - $135 Hotel Rental Service In Ukraine Child Physical Latvia 3rd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus 800-$1500 per child ticket– Credit Card A travel agency of your choice Approximately 10 - 14 days prior to departure Latvian Apartment Room & Board (approx. 7-10 days for third trip) Approx. $100 - $125 per night for apartment $700 - $1250 – Cash. Food approx. $20 - $45 a day per person* - $140 - $315 Apartment Property Manager In Latvia In-CountryLegal Fee** $2,530 (wiring fee included) – Check (for 1 child,) CCAI (wired to Latvia) 1- 2 weeks before third trip US Embassy Medical Exam $215 Embassy-Approved Doctor 200 – Cash USEmbassy approved clinic In Ukraine Ukraine Assistant (total for all 3 tripsRiga, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Latvia Child U.S. Entry Visa $325 – Cash U.S. Consulate KievIn Riga, Ukraine In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Latvia Court Validation Fee Varies by state/county Your $167 – Check County Court After U.S. return State Child’s Colorado Birth Certificate Varies by state State $37.75 – Check Colorado Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption TOTAL ESTIMATE: $31,210 – 28,500 - $46,645 for a couple adopting one 35,500*** ** Additional In Country Legal Feeswillapply formultipleplacements. Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the Ministry of Welfare), non-CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not including citizenshiprefundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/validation deposit) * Please see Explanation Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of , this day of , 20 _. My Commission Expires: / / . Notary’s Signature: CCAI Fee Agreement Rev.01-2020 IS Note: This two-page document is not valid unless all pages are initialed/signed and returned to CCAI. CCAI Latvia Service Agreement For Families in Colorado This CCAI Service Fees Agreement effective as of the date last signed (“Effective Date) is entered into between CCAI and and , a married couple [or a single woman], (hereafter collectively [individually] referred to as the “Adoptive Family” or “We” “you” “your” “our” “us” and, sometimes individually as “I” “my”) (the “Service Agreement”) for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionthe purpose of ensuring mutual understanding between CCAI (the “Primary Provider”) and the Adoptive Family.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH CCAI App Submission First Program Fee (includes Home Study) $6,000 4,650 – Check/ACH CCAI After App Approval IAAME Monitoring & Oversight Fee (per child) $500 – Check/ACH CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 85 per adult for fingerprinting – Check/ Money Order USCIS When filing I600a I600A with USCIS Dossier Preparation Approx. $350 – Check/ Money Order Secretary of State(s) As preparing Dossier Second Program Fee $3,650 3,850 – Check/ACH CCAI Dossier submission to CCAI Home Study Fee As agreed with local home study agency. Your home study agency As agreed with local home study agency. In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator used) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Deposit $200 – Check/ACH CCAI At time of invitation to travel to Ukraine US Domestic & International Airfare (3 trips) $1,300-$1,800 per adult/per trip (economy) + Approx. $1,000 child ticket (one-way) – Credit Card A travel agency/airline of your choice Approximately 10-14 days prior to departure In-Ukraine Travel & Meals/Accommodations (total for all 3 trips, estimated 25 days) $2,285 - $7,500 per couple adopting one child Apartment Rental/ Transportation/ Restaurants/Etc. In Ukraine Child Passport $100 - $150 Local Ukraine Agency In Ukraine Child Physical Exam $215 Embassy-Approved Doctor In Ukraine Ukraine Assistant (total for all 3 trips, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Child U.S. Entry Visa $325 – Cash U.S. Consulate Kiev, Ukraine In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Court Validation Fee Varies by state/county Your County Court After U.S. return State Child’s Birth Certificate Varies by state State Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption TOTAL ESTIMATE: $31,210 – 30,060 - $46,645 44,495 for a couple adopting one child (not including home study costs or citizenship/validation deposit) * Please see Explanation of CCAI Service Fees for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institution.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine Latvia adoption. Expense Amount Pay To Due Application Fee $250 – –Check/ACH CCAI App Submission First 1st Program Fee (includes Home Study) $6,000 6,300– Check/ACH CCAI After App Approval IAAME Monitoring & IAAMEMonitoring &Oversight Fee (per child) Fee# $500 – Check/ACH Check CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 805 plus $30 per adult for fingerprinting in the home – Check/ Check/Money Order Order/Credit Card USCIS When filing I600a with USCIS home study is completed. Dossier Preparation Approx. $350 360 – Check/ Money Order Secretary of State(s) As preparing Dossier. In-Country Translation F ee $2,530 (wiring fee included) -C heck CCAI (wired to Latvia) Dossier Second submission to CCAI 2nd Program Fee $3,650 5,200– Check/ACH CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator used) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Post Adoption Deposit $200 – Check/ACH CCAI At time Acceptance of invitation to travel to Ukraine Referral 1st trip - US Domestic & International Airfare (3 trips) $1,300-$1,800 800 - $1,500 by coach per adult/per trip (economy) + Approx. adult plus $1,000 per child ticket (one-way) one way ticket– Credit Card A travel agency/airline agency of your choice Approximately 107-14 10 days prior to departure In-Ukraine Travel Country Legal Fee** $2,530 (wiring fee included)– Check (for 1 child) CCAI (wired to Latvia) 2 weeks prior to first trip Latvian Apartment & Meals/Accommodations Room & Board (total approx. 19 to 26 days for all 3 trips, estimated 25 daysfirst trip) Approximately $2,285 100-$125 apartment per night. Ranges from $1900-$3,250– Cash. Food approx. $20-$45 a day per person -$420 - $7,500 945 Apartment Property Manager In Latvia Child US Visitor B2 Travel Visa $190 - Cash U.S Consulate, Riga. Latvia In Riga, Latvia 2nd trip - US Domestic & International Airfare $800 - $1,500 by coach per couple adopting one adult plus child, if child Apartment Rental/ Transportation/ Restaurants/Etcis 12 yrs. In Ukraine Child Passport of age or older– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Hotel & Room & Board ( 3 days for second trip Approx. $100 - $150 Local Ukraine Agency 200 for hotel per night. $300 - $600. Food approx. $20 - $45 a day per person - $140 -$315 A Hotel Rental Service In Ukraine Child Physical Latvia 3rd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus 800-$1500 per child ticket– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Apartment Room & Board (approx.7-10 days for 3rd trip) Approx. $100 - $125 per night for apartment $700 - $1250 – Cash.. Food approx.$20 - $45 a day per person* -$140 - $315 Apartment Property Manager In Latvia In-Country Legal Fee** $2,530 (wiring fee included)– Check(for 1 child) CCAI (wired to Latvia) 1- 2 weeks before third trip US Embassy Medical Exam $215 Embassy-Approved Doctor 200 – Cash Clinic In Ukraine Ukraine Assistant (total for all 3 tripsRiga, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Latvia Child U.S. Entry Visa $325 – Cash Cash, submitted first trip U.S. Consulate KievRiga, Ukraine Latvia In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Riga, Latvia Court Validation Fee Varies by state/county Your County Court county court After 3rd U.S. return State Birth Certificate Return Child’s BirthCertificate Varies by state State Vital Statistics Office Your state After 3rd U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption Return TOTAL ESTIMATE: $31,210 – 29,000 - $46,645 for a couple adopting one child (not including citizenship/validation deposit) * Please see Explanation of CCAI Service Fees for details. 36,100 ** InAdditional in Country Legal Fees will apply for multiple placements. Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the Ministry of Welfare), non-country CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not refundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of , this day of , 20 . My Commission Expires: / / . Notary’s Signature: Note: This four -page document is not valid unless all pages are subject initialed/signed and returned to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionCCAI.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine Latvia adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH Personal Check CCAI App Submission First 1st Program Fee (includes Home Study) $6,000 6,300– Check/ACH CCAI After App Approval IAAME Monitoring & IAAMEMonitoring &Oversight Fee (per child) $500 – Check/ACH Check CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 85 per adult for fingerprinting in the home – Check/ Check/Money Order Order/Credit Card USCIS When filing I600a with USCIS home study is completed. Dossier Preparation Approx. $350 360 – Check/ Money Order Secretary of State(s) As preparing Dossier. In-Country Translation F ee $2,530 (wiring fee included) -C heck CCAI (wired to Latvia) Dossier Second submission to CCAI 2nd Program Fee Fee* $3,650 5900– Check/ACH CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator used) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Post Adoption Deposit $200 – Check/ACH CCAI At time Acceptance of invitation to travel to Ukraine Referral 1st trip - US Domestic & International Airfare (3 trips) $1,300-$1,800 800 - $1,500 by coach per adult/per trip (economy) + Approx. adult plus $1,000 per child ticket (one-way) one way ticket– Credit Card A travel agency/airline agency of your choice Approximately 107-14 10 days prior to departure In-Ukraine Travel Country Legal Fee** $2,730 (wiring fee included)– Check (for 1 child) CCAI (wired to Latvia) 2 weeks prior to first trip Latvian Apartment & Meals/Accommodations Room & Board (total approx. 19 to 26 days for all 3 trips, estimated 25 daysfirst trip) Approximately $2,285 100-$125 apartment per night. Ranges from $1900-$3,250– Cash. Food approx. $20-$45 a day per person -$420 - $7,500 945 Apartment Property Manager In Latvia Child US Visitor B2 Travel Visa $190 - Cash U.S Consulate, Riga. Latvia In Riga, Latvia 2nd trip - US Domestic & International Airfare $800 - $1,500 by coach per couple adopting one adult plus child, if child Apartment Rental/ Transportation/ Restaurants/Etcis 12 yrs. In Ukraine Child Passport of age or older– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Hotel & Room & Board ( 3 days for second trip Approx. $100 - $150 Local Ukraine Agency 200 for hotel per night. $300 - $600. Food approx. $20 - $45 a day per person - $140 -$315 A Hotel Rental Service In Ukraine Child Physical Latvia 3rd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus 800-$1500 per child ticket– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Apartment Room & Board (approx.7-10 days for 3rd trip) Approx. $100 - $125 per night for apartment $700 - $1250 – Cash.. Food approx.$20 - $45 a day per person* -$140 - $315 Apartment Property Manager In Latvia In-Country Legal Fee** $2,530 (wiring fee included)– Check(for 1 child) CCAI (wired to Latvia) 1- 2 weeks before third trip US Embassy Medical Exam $215 Embassy-Approved Doctor 200 – Cash Clinic In Ukraine Ukraine Assistant (total for all 3 tripsRiga, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Latvia Child U.S. Entry Visa $325 – Cash Cash, submitted first trip U.S. Consulate KievRiga, Ukraine Latvia In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Riga, Latvia Court Validation Fee Varies by state/county Your County Court county court After 3rd U.S. return State Birth Certificate Return Child’s BirthCertificate Varies by state State Vital Statistics Office Your state After 3rd U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption Return TOTAL ESTIMATE: $31,210 – 29,200 - $46,645 for a couple adopting one 36,200 * Post adoption reports are required by the Ministry until the child reaches 18 years of age (not including citizenship/validation deposit) * Please see Explanation number of CCAI Service Fees for details. additional reports and associated fees to be determined after child referral)** InAdditional in Country Legal Fees will apply for multiple placements. Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the Ministry of Welfare), non-country CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not refundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of , this day of , 20_ . My Commission Expires: / / . Notary’s Signature: Note: This four -page document is not valid unless all pages are subject initialed/signed and returned to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionCCAI.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH Personal Check CCAI App Submission First Child Abuse Record Check $35 – Personal Check CO Dept. of Human Service App Submission 1st Program Fee (includes Home Study) $6,000 6,300 – Check/ACH Check CCAI After App Approval Colorado State Approval $250 – Check Lutheran Family Services via CCAI When Home Study is approved by CCAI IAAME Monitoring & Oversight Fee (per child) Fee# $500 – Check/ACH Check CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 85 per adult for fingerprinting in the home – Check/ Money Order Order/Credit Card USCIS When filing I600a with USCIS Dossier Preparation Approx. $350 – Check/ Money Order Secretary of State(s) As preparing Dossier Second 2nd Program Fee $3,650 4,100– Check/ACH Check CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child Translation fee $6,090 1,030 - $11,090** (depending on facilitator used) – Check (wiring 3,030(wiring fee included) (check) CCAI (wired to Ukraine) Dossier submission to CCAI In-Country Fee** $1,530-$6,030 Check(includes wiring fee) CCAI (wired to Ukraine) First Trip In-Country Fee** $1,030 - $4,030 Check (includes wiring fee) CCAI (wired to Ukraine) Second Trip ( Court) Refundable Citizenship/ Citizenship/Validation Deposit $200 – Check/ACH Credit Card CCAI At time of invitation to travel to Ukraine US Domestic & International Airfare (3 trips) Airfare, per trip $1,300-$1,800 by coach per adult/adult – Credit Card (per trip (economy) + Approx. trip), $1,000 child ticket (one-way) – Credit Card A travel agency/airline agency of your choice Approximately 10-14 days prior to departure In-Ukraine Travel Apartment, Meals & Meals/Accommodations (total for all transportation 3 trips, estimated 25 days) days total Approx. $2,285 45 – $100 for two adults in apartment per night Range from $1,125 -$2,500Approx. $15 - $7,500 60 a day per couple adopting one child person - $375 -$1,500 Apartment Rental/ Transportation/ Restaurants/Etc. Rental Service In Ukraine Child Passport $100 - $150 Local Ukraine Agency In Ukraine Child Physical Exam Medical $215 Embassy-Approved Embassy approved Doctor In Ukraine Ukraine Assistant (total for all Avg. 14 days over 3 tripstrips $50 per day , estimated 14 days) Estimated average $700 total (average $50 per day) Ukraine Assistant Ukrainian Representative In Ukraine Child U.S. Entry Visa $325 – Cash U.S. Consulate Kiev, Ukraine In Ukraine Orphanage fee $500 - $1,000 – Cash Ukraine Orphanage In Ukraine Court Validation Fee Varies by state/county Your $167 – Check County Court After U.S. return State Child’s Colorado Birth Certificate Varies by state State $37.75 – Check Colorado Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) ^ $990 (Online) - $1000 (mail) – Check/Credit Card 1170 USCIS After US Adoption TOTAL ESTIMATE: $31,210 – 33,740 - $46,645 46,315 ** Fees are for one child, additional fees are due if adopting 2 or more children. Fees range dependent on facilitator used. ^Refunded upon CCAI’s receipt of a couple adopting one photocopy of court validation decree, CO birth certificate, Child Arrival File, and child’s Certificate of Citizenship. Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the MSPDCPA), non-CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not including citizenshiprefundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/validation deposit) * Please see Explanation Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of _, this day of _, 20 . My Commission Expires: / / _. Notary’s Signature: Note: This three-page document is not valid unless all pages are initialed/signed and returned to CCAI. CCAI Ukraine Service Agreement For Families in Colorado This CCAI Service Fees Agreement effective as of the date last signed (“Effective Date) is entered into between CCAI and and , a married couple (hereafter collectively referred to as the “Adoptive Family” or “We” “you” “your” “our” “us”) (the “Service Agreement”) for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionthe purpose of ensuring mutual understanding between CCAI (the “Primary Provider”) and the Adoptive Family.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH CCAI App Submission First Program Fee (includes Home Study) $6,000 6,150 – Check/ACH CCAI After App Approval IAAME Monitoring & Oversight Fee (per child) $500 – Check/ACH CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting $775 plus $30 per adult for fingerprinting – Check/ Money Order USCIS When filing I600a with USCIS Dossier Preparation Approx. $350 – Check/ Money Order Secretary of State(s) As preparing Dossier Second Program Fee $3,650 4,850– Check/ACH CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 9,090 - $11,090** (depending on facilitator used) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Deposit $200 500 – Check/ACH CCAI At time of invitation to travel to Ukraine First Trip Travel Invitation US Domestic & International Airfare (3 trips) $1,300-$1,800 per adult/per trip (economy) + Approx. $1,000 child ticket (one-way) – Credit Card A travel agency/airline of your choice Approximately 10-14 days prior to departure In-Ukraine Travel & Meals/Accommodations (total for all 3 trips, estimated 25 days) $2,285 - $7,500 6,000 per couple adopting one child Apartment Rental/ Transportation/ Restaurants/Etc. In Ukraine Child Passport $100 - $150 Local Ukraine Agency In Ukraine Child Physical Exam $215 Embassy-Approved Doctor In Ukraine Ukraine Assistant (total for all 3 trips, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Child U.S. Entry Visa $325 – Cash U.S. Consulate Kiev, Ukraine In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Court Validation Fee Varies by state/county Your County Court After U.S. return State Birth Certificate Varies by state State Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) 1,170 – Check/Credit Card USCIS After US Adoption TOTAL ESTIMATE: $31,210 34,460 – $46,645 41,875 for a couple adopting one child child, 3 trips (not including citizenship/validation deposit) * Please see Explanation of CCAI Service Fees for details. ** In-country fees are subject to an additional 1%-51%-6% Ukraine bank fee, depending on facilitator’s financial institution.

Expenses Necessary to Complete Your Adoption. Your initials below indicate that you have reviewed CCAI’s estimated “Adoption Expense Chronology” (below) and are aware of the expenses necessary to complete your Ukraine Latvia adoption. Expense Amount Pay To Due Application Fee $250 – Check/ACH Personal Check CCAI App Submission First Child Abuse Record Search $35/family – Check CO Department of Human Services App submission 1st Program Fee (includes Home Study) $6,000 – Check/ACH 6,300 Check CCAI After App Approval Colorado State Approval $250 – Check Lutheran Family Services via CCAI When Home Study is approved by CCAI IAAME Monitoring & Oversight Fee (per child) $500 – Check/ACH Check CCAI (forwarded to IAAME) After App Approval (at time of referral for additional child) USCIS Filing & Fingerprinting Dossier Preparation $775 805 plus $30 per adult for fingerprinting – Check/ Money Order in the USCIS When filing I600a with USCIS Dossier Preparation home study is completed home – Check/money order/Credit Card Approx. $350 360 – Check/ Money Order Secretary of State(s) As preparing Dossier Second In-Country Translation Fee $2,530 – (wiring fee included) Check CCAI (wired to Latvia) Dossier submission to CCAI 2nd Program Fee $3,650 5,200– Check/ACH Check CCAI Dossier submission to CCAI In-Country Fee (3 separate payments); additional fees will apply if adopting more than one child $6,090 - $11,090** (depending on facilitator usedCourt Validation Deposit(refundable) – Check (wiring fee included) CCAI (wired to Ukraine) Dossier submission to CCAI First Trip Second Trip ( Court) Refundable Citizenship/ Validation Deposit $200 – Check/ACH Check CCAI At time acceptance of invitation to travel to Ukraine referral 1st trip - US Domestic & International Airfare (3 trips) $1,300-$1,800 800 - $1,500 by coach per adult/per trip (economy) + Approx. adult plus $1,000 for a child ticket (one-way) one way ticket– Credit Card A travel agency/airline agency of your choice Approximately 107-14 10 days prior to departure In-Ukraine Travel Country Fee** $2,530 (wiring fee included) – Check (for 1 child) CCAI (wired to Latvia) 2 weeks prior to first trip Latvian Apartment & Meals/Accommodations Room & Board (total approx. 19 to 26 days for all 3 trips, estimated 25 daysfirst trip) Approx. $2,285 100-$125 apartment per night. Ranges from $1900 -$3,250 – Cash. Food approx. $20 - $7,500 45 a day per couple adopting one person - $420 - $945 Apartment Property Manager In Latvia Child US Visitor B2 Travel Visa $190 - Cash U.S Consulate, Riga. Latvia In Riga, Latvia 2nd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus child, if child Apartment Rental/ Transportation/ Restaurants/Etcis 12 yrs. In Ukraine Child Passport of age or older– Credit Card A travel agency of your choice; Approximately 10 - 14 days prior to departure Latvian Hotel & Room & Board (3 days for second trip) Approx. $100 - $150 Local Ukraine Agency 200 for hotel per night. $300 - $600. Food approx. $20 - $45 a day per person - $60 - $135 Hotel Rental Service In Ukraine Child Physical Latvia 3rd trip - US Domestic & International Airfare $800 - $1,500 by coach per adult plus 800-$1500 per child ticket– Credit Card A travel agency of your choice Approximately 10 - 14 days prior to departure Latvian Apartment Room & Board (approx. 7-10 days for third trip) Approx. $100 - $125 per night for apartment $700 - $1250 – Cash. Food approx. $20 - $45 a day per person* - $140 - $315 Apartment Property Manager In Latvia In-CountryLegal Fee** $2,530 (wiring fee included) – Check (for 1 child,) CCAI (wired to Latvia) 1- 2 weeks before third trip US Embassy Medical Exam $215 Embassy-Approved Doctor 200 – Cash USEmbassy approved clinic In Ukraine Ukraine Assistant (total for all 3 tripsRiga, estimated 14 days) Estimated $700 total (average $50 per day) Ukraine Assistant In Ukraine Latvia Child U.S. Entry Visa $325 – Cash U.S. Consulate KievIn Riga, Ukraine In Ukraine Orphanage fee $1,000 – Cash Ukraine Orphanage In Ukraine Latvia Court Validation Fee Varies by state/county Your $167 – Check County Court After U.S. return State Child’s Colorado Birth Certificate Varies by state State $37.75 – Check Colorado Vital Statistics Office After U.S. return Certificate of Citizenship (where only one parent travels to complete adoption) $990 (Online) - $1000 (mail) – Check/Credit Card USCIS After US Adoption TOTAL ESTIMATE: $31,210 – 28,500 - $46,645 35,500*** ** Additional In Country Legal Fees will apply for a couple adopting one multiple placements. Initials We have read the CCAI Fee Policy/Agreement carefully and understand that it is our responsibility to pay all fees on time in order to receive child placement services from CCAI. We understand that while CCAI’s fees will NOT change throughout our adoption, (unless additional adoptive or post adoptive services are required by the Ministry of Welfare), non-CCAI fees/costs may change/fluctuate while we are in process. We further understand that non-CCAI fees/costs paid throughout this adoption are our responsibility and are not including citizenshiprefundable through CCAI should we discontinue the adoption. We understand that this Fee Policy/validation deposit) * Please see Explanation Agreement must be signed, notarized, and returned to CCAI along with the signed/notarized Service Agreement, 1st Program Fee and IAAME fee (payable via ACH bank transfer, check or money order, or wire transfer). We understand that signing this agreement indicates that we acknowledge and agree to pay the fees and costs of our adoption through CCAI. Husband’s Printed Name: Husband’s Signature Date Wife’s Printed Name: Wife’s Signature Date This document has been subscribed and affirmed before me in the County of , State of , this day of , 20 _. My Commission Expires: / / . Notary’s Signature: CCAI Fee Agreement Rev.10-2020 IS Note: This two-page document is not valid unless all pages are initialed/signed and returned to CCAI. CCAI Latvia Service Agreement For Families in Colorado This CCAI Service Fees Agreement effective as of the date last signed (“Effective Date) is entered into between CCAI and and , a married couple [or a single woman], (hereafter collectively [individually] referred to as the “Adoptive Family” or “We” “you” “your” “our” “us” and, sometimes individually as “I” “my”) (the “Service Agreement”) for details. ** In-country fees are subject to an additional 1%-5% Ukraine bank fee, depending on facilitator’s financial institutionthe purpose of ensuring mutual understanding between CCAI (the “Primary Provider”) and the Adoptive Family.