REPUBLIC OF THE PHILIPPINES )

PROVINCE OF DAVAO DEL NORTE

CITY OF PANABO )S.S.
x---------------------------------------------------x

AFFIDAVIT OF LIST OF EMPLOYEE/S AND GROSS SALES

I, DEL SHIELA MIEN P. DELLOSA, of legal age, Filipino, single and a resident of
Purok 1 Tuganay, Carmen, Davao del Norte, Philippines, by virtue of Secretary’s Certificate
duly notarized by Atty. Aaron Philip B. Cruz, with Document No. 124, Page No. 26, Book No. 1,
Series of 2023, after having been sworn to in accordance with law, do hereby depose and state
THAT:

1.) AMESCO DRUG CORPORATION is a corporation duly established based on existing

laws, rules, and regulations of the Republic of the Philippines, with business address at
Brgy. Salvacion, Panabo City;

2.) I certify that the Gross Sales from January 2022 to December 2022 are as follows:

LINE OF BUSINESS ESSENTIAL NON-ESSENTIAL

RETAILER – MEDICINE P6,678,021.51

RETAILING – DRY P2,291,689.87

GOODS (NON-
ESSENTIAL)

TOTAL P6,678,021.51 P2,291,689.87

3.) I am executing this Affidavit to attest to the truth of the foregoing statements in relation
to the application of renewal of the business permit thereof before the Business Permit
and Licensing Section (BPLS) of the City of Panabo.

IN WITNESS WHEREOF, I have set my hand on this 19th day of January 2023 at
Panabo City, Philippines.

DEL SHIELA MIEN P. DELLOSA

Affiant
UMID ID No.: CRN-0113-0630020-9

SUBSCRIBED AND SWORN to before me this 19th day of January 2023 at Panabo City,
Davao del Norte, Philippines, affiant exhibiting to me his Competent Evidence of Identity.

Doc. No. 473;

Page No. 96;
Book No. 1;
Series of 2023.