REPUBLIC OF THE PHILIPPINES)

PROVINCE OF LA UNION ) S.S.

MUNICIPALITY OF SAN JUAN )

AFFIDAVIT OF CLOSURE OF BUSINESS

(RE: OGRADY’S SPACE RENTAL)

I, CYNTHIA VALDRIZ O’GRADY, of legal age, Filipino, widow, and

presently residing at Urbiztondo, San Juan, La Union, Philippines after having
been duly sworn in accordance with law, do hereby depose and state that:

1. I am the owner of a single proprietorship registered as OGRADY’S

SPACE RENTAL with business address at Urbiztondo, San Juan, La
Union, Philippines;

2. I was issued a Business Permit/Mayor’s Permit on January 01, 2021

by the Office of the Mayor, Municipality of San Juan, La Union;

3. OGRADY’S SPACE RENTAL was registered with the Bureau of Internal

Revenue on September 29, 2011 with Certificate Registration OCN
4RC0001494897;

4. OGRADY’S SPACE RENTAL had formally closed and terminated all of

its operation starting on September 30, 2021;

5. The reason for the termination is due to the continuing COVID 19

pandemic which has rendered our room occupancy nil to date;

6. The business has no outstanding liability and obligation; and

7. I am executing this Affidavit to attest to the truth and veracity of all

the foregoing statements and for all other legal intents and purposes
it may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this 5 th day of

October, 2021 at San Juan, La Union, Philippines.

CYNTHIA V. O’GRADY
Affiant/Proprietor
___________________________________

SUBSCRIBED AND SWORN TO before me this 5th day of October, 2021

at San Juan, La Union, Philippines and the affiant exhibited to me her
competent proof of identity as stated above below her signature and printed
name.

____________________________________
Notary Public
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