REPUBLIC OF THE PHILIPPINES

PROVINCE OF NEGROS OCCIDENTAL

MUNICIPALITY OF ISABELA

OF THE PUNONG BARANGAY

OFFICE OF THE PUNONG BARANGAY

CERTIFICATE OF STORE CLOSURE

To Whom It May Concern:

This document certifies that ___________________________________ a Filipino citizen of legal

age, acting as the Proprietor and Owner of ______________________________________________
with TIN # ____________________ situated at __________________________ Barangay 7, Isabela,
Negros Occidental, has officially closed its operations as of ________________________.

Furthermore, it is affirmed that all pertinent documents related to Business Permits and other
regulatory matters have been duly prepared and shall be promptly submitted to the Municipal
Treasurer's Office for their records.

This certification is issued in response to the request of _______________________________,

and is intended for any legal purpose it may serve for him/her.

Given this ________ day of _________________ at Barangay 7 Poblacion, Isabela, Negros Occidental,
Philippines.

DENNIS M. PLONA
Punong Barangay