» Republic of the Philippines CITY OF MAKATI Office of the City Treasurer BUSINESS TAX DIVISION “The City Treasurer City of Makati Dae Sin/Madam: We, + PresidenOwner/CEO/Board of Director of ya corporition partnership /single proprietorship, engaged in the businesses of > located at » and Darsuant to SEC, 3A. 11(@) “Retirement of Business” ofthe Makati Revised Revenue Code (City Ordinance No2004-A-025) will close/terminatetransfer operations ofthe business/es effective ‘WWe shall not reengage in my /our businesses in Makati without any notification to the City Treastr f Uwe amlare furishing your office the following dateinformation and other supporting documents stated in the requirement below, for your proper evalustion to wit: Gross Sales Receipts forthe Preceding Calendar Vear 20__: ‘Amounting to, ‘Pesos’ (Php. Statement of Taxes paid as por Official Receipts: PERIOD, OR.NO. DATE ‘AMOUNT. 1 Quarter 20 2 Quarter 20 3 Quarter 20, 4 Quarter 20, ia Gross Sates/Receipts forthe Current Calendar Yeat 20__; amounting £9 Pesos (Php__) ‘Tax Due forthe ourrent calendar year Bema ce tae OR.No. Php. UWe swear under OATH that the above mentioned dst/information is rue and correct NOTE: The mere filing of this application does not Signature of Taxpayer ‘automatically relieve the applicant of any tax liability. The books of accounts may be required for verification Position SUBSCRIBED AND SWORN to before me this day of. 10_ at Makati City, the affant exhibiting to me his/her Community Tax, issued at on, : Doe No. Notary Public Beak Seen APPROVED FOR RETIREMENT: JESUSAB.CUNETA CITY TREASURER FOR INQUIRIES, PLEASE CALL 8870-13-56 oF 8870.13.26