I, _________________, of legal age, single/married/widow, Filipino citizen, and presently residing at _____________________, after having been duly sworn to in accordance with law, do hereby depose and say:
1. That I am the (state position) of (state business name) located at (state business address);
2. That said business is registered with the Bureau of Internal Revenue (BIR) on ____________ with Certificate of Registration COR No. _______;
3. That I am applying for the termination of the business ___________ effectively on _____________ because (state reason for closing the business);
4. That the business has no outstanding liability and obligation;
5. That I am executing this affidavit to attest to the truth of all the foregoing statements and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _______ 2014 at ______________, Philippines.