REPUBLIC OF THE PHILIPPINES)

PROVINCE OF ALBAY ) S.S.

TABACO CITY )
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 ________________.

ATTY. ANTHONY CLARK A. GAPIDO

Notary Public Tabaco City
For the Province of Albay
Roll No. 83746
IBP OR No. 227570; June 13, 2022
PTR No. 8843533; July 13, 2022 at Tabaco City
MCLE: N/A (Newly Admitted to the Bar)
2nd Floor Coastal Building Rental, Purok 2,
Morales Street, San Roque,Tabaco City, 4511

Doc No.____;
Page No. 450;
Book No. 35 ;
Series of 2022