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Republic of the Philippines

Province of Surigao del Sur


City of Tandag
CITY OF TANDAG
OFFICE OF THE CITY TREASURER
Awasian, Tandag City, Surigao del Sur
Tel No. (086) 211-3147

AFFIDAVIT OF RETIREMENT OF BUSINESS


I,_________________________, of legal age, Filipino citizen, and a resident of
_______________________________________, under oath state that:

1. I am the owner of _______________________ (name of business), a


_________________ business (type of business) located at
____________________________________________address);

2. As such, I have been issued a Business Permit with an Assigned Code Number
____________________;

3. I have decided to completely stop my business operation within this city


effective __________________ (date of stoppage) as verified by the Inspector duly
assigned by the City Treasurer for that matter. A copy of the said verification and
recommendation for approval of the application is hereto attached as Annex
“A”;

4. In compliance with the existing ordinance, I undertake to:


a. submit a copy of my business’ gross sales or receipts for the current
calendar year within thirty (30) days from the date above-stated; and,
b. pay the tax due: Provided that if the tax paid during the current year be
less than the tax due for the same year based on the gross sales or
receipts, I undertake to pay the difference;
c. surrender the Business Permit issued to me to the Business Permits and
Licensing Office, who will then forward the same to the City Treasurer’s
Office for its cancellation in his books;

5. I understand that only upon my full and/or complete compliance of the


undertakings in the preceding paragraph shall my business be considered retired
and/or terminated, and the liability imposed upon me to pay the taxes thereon,
removed;

6. This affidavit of application for retirement and/or termination of my business is


made in good faith, and not merely a simulation of the same;

7. I am executing this affidavit to attest to the truth and veracity of the foregoing
statements and for whatever legal purpose this may serve best.

IN WITNESS WHEREOF, I have hereunto set my hands this _____ day of


_______________, 2019_ at Tandag City, Surigao del Sur, Philippines.

________________________________
Affiant
Valid ID: ____________________________

SUBSCRIBED AND SWORN to before me this _____ day of ___________________, 2019


in the City of Tandag, Surigao del Sur, Philippines, by affiant who has satisfactorily
proven to me his identity thru his valid ID above-described and who is personally known
to me to be the same person who presented the foregoing documents which they
voluntarily signed in my presence.

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