AFFIDAVIT OF CANCELLATION
WITH NO FINANCIAL OBLIGATION
I, ____________, of legal age, Filipino, with address at ________________, after having sworn to in
accordance with law, hereby depose and state that:
1. I am a registered owner of a business under the trade name ______________ located at
______________ ;
2. The above-stated business was duly registered at the Department of Trade and Industry (DTI) on
______________ and was issued Certificate of Registration with No. ______________.
3. At present, I am causing the cancellation of the said registered business due to change of
territorial scope.
4. As far as my personal knowledge as the registered owner, I attest to the fact that
______________ has no outstanding financial obligation to any individual, public or private
corporation or entities,
5. I am executing this affidavit to the attest the truthfulness of the foregoing declarations under
penalties of perjury to respectfully request te DTI to CANCEL Certificate of Registration No.
______________, and for other legal purposes.
AFFIANT FURTHER SAYETH NAUGHT.
IN WITNESS WHEREOF, I hereby set my hand this ___________________ in __________________,
Philippines.
______________
AFFIANT
SUBSCRIBED AND SWORN to before me, this _____________________ in
_____________________, affiant who exhibited her government ID as competent proof
of her identity.
Doc. No. _______
Page No. ______
Book No. ______
Series of 2021