SWORN STATEMENT | RICARDO DE ROMA MANLULU, of legal age, currently residing at 236 SAMPAGUITA ST STO CRISTO SAN PABLO CITY, LAGUNA, after having been duly sworn in accordance with the law, do hereby depose and state that: 1. | am the owner of the Business Name Registration duly registered with the Deparment of Trade and Industry (DT!) with the following details: Business Name: RECTO’S RICE DEALER Territorial Scope: CITY/MUNICIPALITY Certificate No./Business Name No.: 03936362 Date of Registration: FEBRUARY 04, 2016 N .. Pursuant to DTI’s Department Administrative Order No. 18-07, Series of 2018, Rule IX Section 1.1 Voluntary Cancellation, it is my initiative to request for the cancellation of my Business Name Registration due to the following condition(s): (check the appropriate condition(s)) Cl Ceases to carry on with the business under the BN prior to its expiry date; T Sale or transfer of the business to any other person; 1 Upon conclusive determination that a prior owner and lawful user of an identical or confusingly similar BN exists; 1 Transfer of business to another geographical location beyond or outside the registered BN’s territorial scope. 3. As far as my personal knowledge as the registered owner, | attest to the fact that this request for cancellation is not intended to defraud creditors and | have no outstanding and pending financial obligation in connection to my business or | have notified all the creditors of this cancellation. 4. lam executing this sworn statement to attest the truthfulness of the foregoing declarations under penalties of perjury to respectfully request DTI to CANCEL the above-mentioned Business Name Registration, moreover to serve all legal intents. FURTHER AFFIANT SAYETH NAUGHT. IN WITNESSWHEREOF, | hereby affix my signature on this__APRydyh#021_ 20 at [City/Municipality]__ SAN PABLO city : Ricn2 yo Cas Affiant Signature over printed name For DTI use only APR 20 2021, SUBSCRIBED AND SWORN TO BEFORE ME on this _day of 20__ at [DTI Officey_ SAN . Affiant exhibiting to me his/hey{Type of ID} with number bearing her photograpl G Doc. No. 150 e Page No / Book No. zoe gic frown gta Director Series No. 287 Roll No. 58593 TIN 244-198-1(7-000 cs ‘Rn, 26, 2F New La Suene Bldg, . Pulao Se, SPC Laguaa Vengo