REPUBLIC OF THE PHILIPPINES }

PROVINCE OF CAGAYAN }S. S.

CITY OF TUGUEGARAO }

AFFIDAVIT OF LOSS

I, Cheenee Mariekeith C. Vehemente, of legal age, Filipino, married, and a resident of

Santol St. Pengue, Ruyu, Tugegarao City, Cagayan, after being duly sworn to in accordance with
law, hereby depose and state:

1. That I am the sole proprietor of Boss Crae Net and Prints located at Caggay,
Tuguegarao City, Cagayan;

2. That the said business had been duly registered with the Bureau of Internal Revenue
last_________

3. That the said business had ceased its operations since ___________ and did not earn
any income therafter;

4. That the following documents related to the business had been lost:

a. BIR books and ledgers

b. Official Receipts
c. Others

5. That diligent effort to locate the same turned futile;

6. That in view thereof, I now desire and hereby request the BIR Tuguegarao City, to
consider the finality of closure of said business in their system;

7. That I am executing this affidavit to attest to the foregoing facts and for any legal
purpose it may serve.

IN WITNESS WHEREOF, I hereby set my hand this 21 st day of May, 2024 in

Tuguegarao City, Cagayan.

CHEENEE MARIEKEITH C. VEHEMENTE

Affiant

SUBSCRIBED and SWORN to before me this _____ day of ____________________.

Affiant exhibiting to me his/her_______________________issued at ____________________
and issued on ___________________.

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