REPUBLIC OF THE PHILIPPINES)

________________________) S.S.

AFFIDAVIT CANCELLATION OF BUSINESS

I, , of legal age, married and a resident of Collat Masinloc Zambales, after

having been duly sworn in accordance with law do hereby depose and
state:

That I am the owner of the business name BUBBLES ML LAUNDRY SHOP

which is registered with the Bureau of Internal Revenue (BIR);

That I am applying for the termination of the business, BUBBLES ML

LAUNDRY SHOP, registered with the BIR in (date of registration), with
Certificate of Registration OCN No. (Certificate number), which I decided to
close effective (effectively date of closure);

That the reason for the termination is due to financial difficulty;

That the business has no outstanding liability and obligation;

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

_________________ at _____________, Philippines.

Affiant

SUBSCRIBED AND SWORN to before me this __th day of _______________

at ____________, Philippines.

Doc. No. : ____;

Page No. : ____;
Book No. : ____;
Series of 2019