Republic of the Philippines )

City of ______               ) S.S.

x--------------------------x

AFFIDAVIT OF CESSATION OF BUSINESS OPERATION

            I, _________________, of legal age, single/married/widow, Filipino

citizen, and presently residing at _____________________, after having been
duly sworn to in accordance with law, do hereby depose and say:

1.  That I am the (state position) of (state business name) located at (state

business address);

2.  That said business is registered with the Bureau of Internal Revenue (BIR) on

____________ with Certificate of Registration OCN No. _______;

3.  That I am applying for the termination of the business ___________ effectively

on _____________ because (state reason for closing the business);

4.  That the business has no outstanding liability and obligation;

5.  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 ____ day of

_______ 2014 at ______________, Philippines.

                                                                                    ________________
                                                                                                Affiant
                                                                                   

            SUBSCRIBED AND SWORN to before me this ____ day of ______

2014 in _________, Philippines, affiant exhibiting to me his/her competent
evidence of identity by way of _______________ issued at ___________
on ________________.

Doc No. :  _____                                                             

Page No.: ______                                           
Book No.: ______                                              
Series of 2014                                                                Notary Public