Republic of the Philippines

REGIONAL TRIAL COURT

8th Judicial Region
Branch 10
Abuyog, Leyte

Republic of the Philippines)

____________, ________ ) s.s.

AFFIDAVIT OF CESSATION OF BUSINESS OPERATION

I, ______________________, of Legal Age, Filipino, Married and with residential address

at Tacloban, City after having been duly sworn to in accordance with law, hereby depose and
state:

1. That I am the Sole Proprietor of Gaisano Capital at Tacloban City.

2. That said business is registered with the Bureau of Internal Revenue (BIR) on
January 16, 2016 with Certificate of Registration OCN No. 1888999-11

3. That I am applying for the termination of the business effectively on January 30,
2017 because I am about to migrate to the United States;

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
6. I therefore executed this Affidavit to cause the necessary changes in the
registration of the above-mentioned vehicle in the Land Transportation Office,
to attest the truth I mentioned herein and for whatever legal purposes it may
serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____day of

____________ 20__ in ______________ City, Philippines.

________________________
Affiant

Subscribed and sworn xxxxxxx