Sample-affidavit-of-closure V2.doc

REPUBLIC OF THE PHILIPPINES ) PROVINCE OF MASBATE )S.S CITY OF MASBATE ) X--------------------------X

AFFIDAVIT OF TERMINATION OF BUSINESS

I, Alice Tudlasan Bernal, of legal age, Single and a resident of Sitio Taisan, Barangay Calumpang, Milagros, Masbate after having been duly sworn in accordance with law do hereby depose and state: 1. That I am the registered owner of the business name DMX Xyber Café with the Bureau of Internal Revenue (BIR) under TIN No. 289-303-992-000; 2. That I am applying for the termination/closure of the business name, DMX Xyber Café, registered with the BIR under TIN No. 289-303-992-000; 3. That the reason for the termination is due to the fact that DMX Xyber Café ceased to operate since 2014 but I was not able to request for termination of the business with the BIR at an earlier date; 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 statement and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I have hereunto set my ___________________, 2018 at Masbate City, Philippines.

hand

this

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of

ALICE T. BERNAL Affiant CTC No: __________ Issued on: _________ At: _______________

SUBSCRIBED AND SWORN to before me this ______ day of ___________________, 2018 in Masbate City, Philippines, by affiant, known to me to be the same person who executed and personally signed the foregoing document before me and avowed under penalty of law to the whole truth of the contents hereof.

__________________________ Subscribing Officer Doc. No. _______; Page No. _______; Book No. _______; Series of 2018

REPUBLIC OF THE PHILIPPINES ) PROVINCE OF MASBATE )S.S CITY OF MASBATE ) X--------------------------X

AFFIDAVIT OF LOSS

I, Alice Tudlasan Bernal, of legal age, Single and a resident of Sitio Taisan, Barangay Calumpang, Milagros, Masbate after having been duly sworn in accordance with law do hereby depose and state: 1. I am holder/owner/ or possessor of the business name certificate of DMX Xyber Café or Original Certificate of Registration, the duplicate copy of its application form, books of accounts and unused Official Receipts; 2. I have recently discovered the said items are irretrievably lost and can no longer be found despite diligent efforts to locate the same; 3. I execute this affidavit to attest to the truth of the foregoing.

IN WITNESS WHEREOF, I have hereunto set my ___________________, 2018 at Masbate City, Philippines.

hand

this

_____

day

of

ALICE T. BERNAL Affiant CTC No: __________ Issued on: _________ At: _______________

SUBSCRIBED AND SWORN to before me this ______ day of ___________________, 2018 in Masbate City, Philippines, by affiant, known to me to be the same person who executed and personally signed the foregoing document before me and avowed under penalty of law to the whole truth of the contents hereof.

__________________________ Subscribing Officer Doc. No. _______; Page No. _______; Book No. _______; Series of 2018

January 25, 2018

Bureau of Internal Revenue Revenue District Office No. 70 Masbate City, Masbate To whom it may concern, This is to request your good office for the closure/termination of the business name DMX Xyber Café registered under my name, Alice T. Bernal, with TIN No. 289-303-992-000 due to the fact that the business ceased its operation since year 2014. My affidavit for termination of business is hereto attached as “Annex A”. It has recently come to my attention that it is recorded as an open case in your tax system due to my failure to request for its closure/termination at an earlier date. I also understand that penalty shall be continuously imposed on my TIN No. 289-303-992-000 until the business name DMX Xyber Café is officially closed/terminated and that my inadvertence resulted to accrued penalties. Please be assured that I will settle any and all amounts due to the BIR. Furthermore, the business name certificate of DMX Xyber Café and other pertinent documents relative to the closure/termination of the business can no longer be found despite my diligent efforts to locate it, resulting from the passage of time. My affidavit of loss is hereto attached as “Annex B” to support the same. In view of this, I respectfully request for the closure/termination of the business name DMX Xyber Café registered under my name with TIN No. 289-303-992-000. Thank you for your attention to this matter.

Sincerely,

ALICE T. BERNAL CP No. 09500094133