REPUBLIC OF THE PHILIPPINES)

PROVINCE OF PANGASINAN )S.S.

CITY OF ALAMINOS )
X - - - - - - - - - - - - - - - - - - - - - - ---X

AFFIDAVIT OF MUTILATED
CERTIFICATE OF REGISTRATION

THAT I, JONATHAN R. NACAR, of legal age, Filipino citizen, and a

with business address at Nepo Mart, Poblacion, Alaminos City,
Pangasinan, after having been duly sworn to in accordance with law
hereby depose and say:

1. That I am owner/proprietor of NACAR MEAT DEALER, with TIN No.

940-207-989-000 and a holder of CERTIFICATE OF REGISTRATION
issued by the Bureau of Internal Revenue;

2. That said COR was being kept/placed in my stall;

3. That when I was to look for it, I noticed that said certificate of
registration was destroyed, mutilated and of no use;

4. That I am executing this affidavit to attest to the truth of the foregoing

facts and for any legal intent it may best serve.

IN WITNESS WHEREOF, I have hereunto set my hand this

________________ at Alaminos City, Pangasinan.

JONATHAN R. NACAR
AFFIANT

SUBSCRIBED AND SWORN to before me, this ________________

at Alaminos City, Pangasinan.

Doc. No.______
Page No.______
Book No.______
Series of 2018