Republic of the Philippines)

Quezon City)S.S.

AFFIDAVIT OF BUSINESS CLOSURE/RETIREMENT

I, __________________, of legal age, married,

Filipino, with residence and postal address at
______________________, Quezon City, Philippines, after
having been duly sworn to in accordance with law, do
hereby depose and say:

1.That I am the owner of a business establishment

named “________________” located at
________________;

2. That I have been issued a BUSINESS PERMIT on

_____________ by the Quezon City Government;

3. That on December 2017, I closed the said

business due to lack of manpower and low sale;

4.That since the period of registration of my

business there was no amount received to
be recorded as either gross or net profit

5. That I execute the foregoing instrument in order

to attest the truth of the above facts for all
legal intents and purposes it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand

this _____ day of ____________ at Quezon City,
Philippines.

____________________
Affiant

SUBSCRIBED AND SWORN to before me this _____ day of

______________ at Quezon City, Philippines.

Doc. No. ______

Page No. ______
Book No. ______
Series of 2019