REPUBLIC OF THE PHILIPPINES)

MUNICIPALITY OF GERONO )s.s.

PROVINCE OF TARLAC )

AFFIDAVIT OF CLOSURE

I, ALLAN VISAYA DE DIOS, of legal age, married, Filipino and a resident of

Dicolor, Gerona, Tarlac, after having duly sworn in accordance with law, hereby depose
and state, to wit:

1. That I am the bona fide owner or proprietor of Business with registered name of
AQUA DE COLOR WATER STATION

2. That I am executing this Affidavit of CLOSURE in my said capacity.

3. That I execute this affidavit of CLOSURE to formally close down my said

registered business which have already stopped its operation since the month of
May 1, 2018

4. That since the period of registration of my business there was no amount

received to be recorded as either gross or net profit. That there was no amount
received as payment for the operation of the business.

5. That said CLOSURE of business was due to no sale or no transaction

6. I am executing this affidavit therefore for all legal intents and purposes with
regard to the closure of said business.

IN WITNESS WHEREOF, I have hereunto set my hand this___________ at Tarlac City.

ALLAN VISAYA DE DIOS

AFFIANT

SUBSCRIBED AND SWORN to before me this ______________ at Tarlac City.

Doc. No.________
Page No._______
Book No. _______
Series of _______