Republic of the Philippines }

Province of Camarines Sur }

AFFIDAVIT OF CANCELLATION

WITH NO FINANCIAL OBLAGATION

I, LAINA DIABRANG CADALAY ,of legal age,married,Filipino citizen, and a resident of

Pt.leelin Street Poblacion Tigaon Camatines Sur, after having sworn to in accordance with Law,
hereby depose and state:

1. That I am the registered owner of a business under the trade name SADAM AND SAIF
FOOTWEAR CENTER, located at Poblacion Tigaon Camarines Sur
2. That the above-said business was duly register at the Department of Trade and Industry
(DTI) on 7 FEBRUARY 2014 and was issued Certificate Of Registration with
NO.03110705
3. That at present I am causing the cancellation due to the facts of the change of name of
the said business and the execution of the foregoing affidavit is in Support;
4. That as far as my personal knowledge as the registered owner, I attest to the fact that
SADAM AND SAIF FOOTWEAR CENTER, has no standing financial obligation to any
individual, public or private corporation or entities;
5. That I am executing this affivadit to attest to the truthfulness of the foregoing
declarations under penalties of perjury to respectfully request the DTI to CANCEL
Certificate of Registration, NO.03110705, moreover to serve all legal intents.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereby affix my signature on this 8th day of January 2019 at
Poblacion, Tigaon, Camarines Sur.

LAINA D. CADALAY
Affiant.

SUBCRIBED TO BEFORE ME on this 8th day of January 2019 at __________________

the affiant exhibiting to me her PhilHealth ID with ID number 10-025198902-2, bearing her
photograph and signature and avowed the truthfulness of the foregoing declaration.

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