Republic of the Philippines )

City of ______ ) S.S.

x--------------------------x

AFFIDAVIT OF CESSATION OF BUSINESS OPERATION

I, _________________, of legal age,

single/married/widow, Filipino citizen, and presently
residing at _____________________, after having been duly
sworn to in accordance with law, do hereby depose and
say:

1. That I am the (state position) of (state business

name) located at (state business address);

2. That said business is registered with the Bureau of

Internal Revenue (BIR) on ____________ with Certificate
of Registration OCN No. _______;

3. That I am applying for the termination of the business

___________ effectively on _____________ because (state
reason for closing the business);

4. That the business has no outstanding liability and

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 ____ day of _______ 2014 at ______________,
Philippines.

____________
____

Affiant
 SUBSCRIBED AND SWORN to before me
this ____ day of ______ 2014 in _________,
Philippines, affiant exhibiting to me his/her competent
evidence of identity by way of _______________ issued at
___________ on ________________.

Doc No. : _____

Page No.: ______
Book No.: ______
Series of 2014
Notary Public