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