REPUBLIC OF THE PHILIPPINES )

NORZAGARAY, BULACAN )

AFFIDAVIT OF CANCELLATION with no FINANCIAL OBLIGATION

KNOW ALL MEN BY THESE PRESENTS:

I, _______________________________, of legal age, married, Filipino citizen, and a resident of

Barangay Matictic, Norzagaray, Bulacan, 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 FREEZE
AIR__________ located at Barangay Matictic, Norzagaray, Bulacan;

2. That the above-said business was duly registered at the Department of Trade and
Industry (DTI) on ______________ and was issued Certificate of Registration
No. ________;

3. That at present I am causing the cancellation due to the facts that said business is no
longer existing 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
FREEZE AIR _________, has no standing financial obligation to any individual,
public or private corporation or entities;

5. That I am executing this affidavit to attest the truthfulness of the foregoing

declarations under penalties of perjury and to respectfully request the
DTI to CANCEL Certificate of Registration No. _______________, moreover to serve
all legal intents.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I hereby affix my signature this 20 th day of April 2015 at Norzagaray,
Bulacan.

_____________________
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this 20th day of April 2015 at Norzagaray,
Bulacan. Affiant exhibiting to me his Driver’s License with license number
__________________, bearing her photograph and signature and avowed the truthfulness of
the foregoing declarations.

Notary Public

Doc. No. ________

Page No. ________
Book No. ________
Series of 2015