REPUBLIC OF THE PHILIPPINES )

PROVINCE OF TARLAC ) S.S.

MUNICIPALITY OF PANIQUI )

AFFIDAVIT OF GROSS SALES

FOR THE YEAR 2017

I, RYAN M. DELA CRUZ, of legal age, Filipino, married and with resident address at
Barangay Tablang, Paniqui, Tarlac, after having been duly sworn to according to law hereby
depose and state:

1. That I am the owner/proprietor of “R.M. DELA CRUZ TRADING”, located

at Barangay Tablang, Paniqui, Tarlac;

2. That my Gross Sales for the year 2017 is SIXTY EIGHTY THOUSAND TWO
HUNDRED PESOS (Php 68,200.00), 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 17 th day of January, 2018, at
Paniqui, Tarlac.

RYAN M. DELA CRUZ

Affiant
CTC No. 28571814
Issued on January 17, 2018
Issued in Paniqui, Tarlac

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

Tarlac, this 17th day of January, 2018, by Ryan M. Dela Cruz, personally known to me and who
in person signed before me the foregoing Affidavit.

Doc. No. _______;

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