REPUBLIC OF THE PHILIPPINES)

Candelaria, Quezon Province )S.S.

AFFIDAVIT
OF VOLUNTARY CANCELLATION OF BUSINESS NAME REGISTRATION

I, ___________________________, Filipino, of legal age, married, and

presently residing at ______________________________________________________,
Philippines, after being sworn to in accordance with law, hereby depose and
state:

1. That I am the registered owner of a business under the trade

name _____________________________________ located at
____________________________________________________, Philippines;

2. That the above-said business was duly registered at the

Department of Trade and Industry (DTI) on 28 February 2019 to
28 February 2024 and was issued Certificate of Business Name
Registration No. ________________;

3. That at present I am causing the cancellation of the business

name registration due to the change in the ownership of the said
business from my name to my brother;

4. That the cancellation of my DTI-registered business name is not

intended to defraud creditors, and that I have no outstanding and
pending financial obligations in connection with my business to
any individual, public or private corporation or entities;

5. As such, I am executing this Affidavit to:

a) Attest to the truthfulness of the foregoing
statements:
b) Process with Department of Trade and Industry the
cancellation of Business Name Registration No.
__________________; and
c) For any legal purpose/s it may serve.

FURTHER AFFIANT SAYETH NAUGHT.

_____________________________
Affiant

SUBSCRIBED AND SWORN to me before this ___ day of ____________

2024 at Candelaria, Quezon Province. Affiant exhibited to me his LTO Driver’s
ID with License No. ________________ issued on _____________.

Doc. No. __________;

Page No. __________;
Book No. __________;
Series of 2024.