REPUBLIC OF THE PHILIPPINES )

PROVINCE OF TARLAC ) S.S.

MUNICIPALITY OF PANIQUI )

AFFIDAVIT OF GROSS SALES

FOR THE YEAR 2017

I, ERLINDA A. VALDEZ, of legal age, Filipino, married and with resident address at
Barangay Nilasin 2nd, Pura, Tarlac, after having been duly sworn to according to law hereby
depose and state:

1. That I am the owner/proprietor of “VALDEZ CANTEEN”, located at

Barangay Poblacion 1, Pura, Tarlac;

2. That my Gross Sales for the year 2017 is THREE HUNDRED FIFTY
THOUSAND PESOS (Php 350,000.00), Philippine Currency;

3. That I am executing this Affidavit of Gross Sales in order to attest to the truth
and veracity of the foregoing statement and for the purpose of securing my
Business / Mayor’s Permit for the year 2018.

FURTHER, AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 29 th day of January, 2018,
at Paniqui, Tarlac.

ERLINDA A. VALDEZ
Affiant
CTC No. _____________
Issued on _____________
Issued in _____________

SUBSCRIBED and SWORN to before me, in the Municipality of Paniqui, Province of

Tarlac, this 29th day of January, 2018, by Erlinda A. Valdez, personally known to me and who in
person signed before me the foregoing Affidavit.

Doc. No. _______;

Page No. _______;
Book No._______;
Series of 2018