Republic of the Philippines )

City of Ormoc )S.S.

AFFIDAVIT OF CESSATION OF BUSINESS

I, TEOFILO A. CORDERO, of legal age, Filipino and a resident of

Brgy. District 13, Ormoc City, Leyte, Philippines, after having been sworn
to in accordance with law, do hereby depose and say THAT:

1. That I am the owner of LPG RETAILER located in Brgy.

Damulaan, Albuera, Leyte;

2. That sometime in 2018 said business has ceased to operate due to my

health condition suffering from a severe pain of my scrotum;

3. That I derived no income from said business during said period up to

the present so I decided to close the same.

4. That I execute this affidavit to attest to the truthfulness of the

foregoing statements and for the purposes of proving cessation of my
business.

IN WITNESS WHEREOF, I have hereunto set my hand this _ day

of _______, 2018 at Ormoc City, Philippines.

TEOFILO A. CORDERO
Affiant
OSCA No. 18610
Issued on/at: 06-11-2015/Ormoc City

SUBSCRIBED AND SWORN TO before me this _ day of _______,

2019 at Ormoc City, Philippines.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2019