REPUBLIC OF THE PHILIPPINES)

BATANGAS CITY ) S.S.

AFFIDAVIT
RE: TERMINATION OF BUSINESS

I, ZENAIDA A. GALVEZ of legal age, single and a resident of #106 Montalbo

Road, Brgy. Bolbok, Batangas City, after having been duly sworn in accordance with law
do hereby depose and state:

That I am the owner of the business name ZAG GAS STATION AND
SERVICES/CONVENIENCE STORE which is registered with the Bureau of Internal
Revenue (BIR);

That I am applying for the termination of the business, ZAG GAS STATION
AND SERVICES/CONVENIENCE STORE, registered with the BIR in January 31, 2017
, with Certificate of Registration OCN No. 1RC0000930160, which I decided to close
effective December 30, 2019;

That the reason for the termination is due to the inability to generate sufficient
business profits;

That the business has no outstanding liability and obligation;

That I am executing this affidavit to attest to the truth of all the foregoing
statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 30 th day of

December, 2019 at Batangas City, Philippines.

ZENAIDA AMUL GALVEZ

Senior Citizen ID No. 669033
Issued on September 2009

SUBSCRIBED AND SWORN to before me this 16th day of December,

2019 at Batangas City, Philippines.

Doc. No. 62:

Page No. : 14
Book No. : 1 ;
Series of 2019.

ATTY. JURYSON ALBOTRA GALVEZ

NOTARY PUBLIC for BATANGAS
Commission No. 2019-46 until 12/31/2020
Roll of Attorneys No. 73193
IBP No. 087678/Pasig City/5-10-19
PTR No. 3458081/Batangas City/7-1-19
MCLE Exempt (Gov. Board No.1, s.2008)
JAG Law Office, Diversion Rd, Bolbok, Batangas City