REPUBLIC OF THE PHILIPPINES)

PROVINCE OF CAGAYAN ) S.S

MUNICIPLAITY OF ALCALA)

AFFIDAVIT OF CANCELLATION OF BUSINESS NAME

I, LESLIE CLEMENT M. SINGSON, of legal age, single, Filipino citizen and a resident of
Centro Norte, Alcala, Cagayan, and I hereby swear on the following:

1. That I am the registered owner of ZES CONVENIENCE STORE which is located at

Centro Norte, Alcala, Cagayan;

2. That I am applying for cancellation of the registered business name, ZES

CONVENIENCE STORE, registered on September 01, 2022, with DTI No. 4131487
effective immediately;

3. That I have decided to close the said business

4. That the business has no outstanding liability or 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 19 th day of January 2023 at
Alcala, Cagayan, Philippines.

LESLIE CLEMENT M. SINGSON

Affiant

SUBSCRIBED AND SWORN to before me this 19th day of January 2023 at Alcala, Cagayan,
Philippines.

Doc. No. : ________;

Page No. : ________;
Book No. : ________;
Series of 2023.