Republic of the Philippines)

Province of Leyte ) S.S

City of Ormoc )

AFFIDAVIT OF CANCELLATION
WITH NO FINANCIAL OBLIGATION

I, ROMEL RODRIGUEZ RICARTE, of legal age, Filipino citizen, married and a resident of Brgy. Punta,
Ormoc City, Leyte, after having sworn to in accordance with law, hereby depose and state:

1. That I am the registered owner of a business under the trade name ALLIEDTECH INTERNET
CAFÉ located at Bautista Bldg., Bonifacio St., Ormoc City, leyte;

2. That the above-said business was duly registered at the Department of Trade and Industry
(DTI) on 04 JUNE 2015 and was issued Certificate of Registration with No. 03607688;

3. That at present I am causing the cancellation due to the facts that I am applying for the closure
of the said business and the execution of the foregoing affidavit is in support;

4. That as far as my personal knowledge as the registered owner, I attest to the fact that
ALLIEDTECH INTERNET CAFE, has no creditors or outstanding and pending financial
obligations to any individual, public or private corporation or entities, in connection with the
business associated with the said Business Name as of the date of application for cancellation.

5. That I am executing this affidavit to attest the truthfulness of the foregoing declarations under
penalties of perjury to respectfully request of the DTI to CANCEL Certificate of Registration,
No. 03607688, moreover to serve all legal intents.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITHNESSWHEREOF, I hereby affix my signature of this_________day of__________________at

Ormoc City, Leyte.

ROMEL R. RICARTE
Affiant

SUBSCRIBED AND SWORN TO BEFORE ME on this________day of ___________________________at

Ormoc City, Leyte. Affiant exhibiting to me his/her____________________________with
____________________________, bearing her photograph and signature and avowed the truthfulness of
foregoing declarations.

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