REPUBLIC OF THE PHILIPPINES)

_____________________________ ) S.S.

AFFIDAVIT
RE: TERMINATION OF BUSINESS
I, ________________________, of legal age, married and a resident of
________________________________________, after having been duly sworn in
accordance with law do hereby depose and state:
That I am the owner of the business name __________________________ located
at ____________________________________ which is registered with the Bureau of
Internal
Revenue
(BIR)
Revenue
District
No.
________
with
TIN
______________________;
That
I
am
applying
for
the
termination
of
the
business,
__________________________,
registered
with
the
BIR
in
__________________________,
with
Certificate
of
Registration
OCN
No.
______________________, which I decided to close effective __________________;
That
the
reason
for
the
termination
____________________________________________________;

is

due

to

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
CTC No:
Issued on:
At:

SUBSCRIBED AND SWORN to before me this __th day of _______________ at

____________, Philippines.

Doc. No.:
Page No.:
Book No. :

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