REPUBLIC OF THE PHILIPPINES )

CITY OF BATANGAS )S.S.

x-------------x
AFFIDAVIT OF CLOSURE

I, LUCILA P. NABOS, married, of legal age, Filipino and a resident of Brgy. Kumintang Ibaba,
Batangas City, after being sworn according to law depose and say, THAT:

Affiant is the sole proprietor of SARI-SARI STORE with business address at Kumintang Ibaba,
Batangas City;

Said business has been duly registered with Department of Trade and Industry.

In view of the fact that SARI-SARI STORE already stopped doing business, affiant is
constrained to close it down.

I have executed this affidavit to attest to the truth of the foregoing, to notify the proper
authorities particularly the Department of Trade & Industry (DTI) and Bureau of Internal Revenue (BIR)
and for all legal purposes proper under the premises.

IN WITNESS WHEREOF, I have hereunto set my hand this ________________ at Batangas

City.

LUCILA P. NABOS
Affiant
OSCA ID. No. 04-10-05-034-424

SUBSCRIBED AND SWORN to before me this ________________ at Batangas City, affiant, whom
I have identified through competent evidence of identity, exhibited to me his identifying document stated
above.

ROBERTO IÑIGO D. SANCHEZ

Notary Public
Until December 31, 2017
Doc No. ___; PTR No. 2801385 01.05.2017 Bats. City
Page No. ___; IBP No. 1052875 01.05.2017 Bats. City
Book No. XX; Roll No. 61644 Serial No. 2016-31
Series of 2017. Zenaida Arcade, 43 M.H. Del Pilar St., Batangas City