Republic of the Philippines )

City of Santa Rosa

) S.S.
AFFIDAVIT
I, MA. VIRGINIA M. CAMU, of legal age, single, Filipino citizen, and
presently residing at Phase 1 C Blk. 39, Lot 11, San Lorenzo, City of Santa
Rosa, Laguna, after having been duly sworn to in accordance with law, do
hereby depose and say:
1. That I am the sole proprietress of MA. VIRGINIA M. CAMUS
GARDEN SUPPLIES, a business duly registered with the
Department of Trade and Industry, with business address at Blk.
39 Lot 11 1C, San Lorenzo South, Brgy. Dita, City of Santa Rosa,
Laguna;
2. That sometime in 2006, said business has ceased its operation
due to bankruptcy;
3. That for this reason, no income was generated from said business
since its cessation;
4. Thus, I am executing this affidavit to attest to the truth of all the
foregoing facts and statements to inform the proper authorities
concerned, and for whatever legal purpose it may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this 14 th day
of June 2016 at the City of Santa Rosa, Laguna, Philippines.

MA. VIRGINIA M. CAMU

Affiant
SUBSCRIBED AND SWORN to before me this 14th day of June
2016 in the City of Santa Rosa, Laguna, Philippines, the affiant exhibiting
to me her _________________ issued at ___________________.

Doc No. ____;

Page No. ___;
Book No. ___;
Series of 2016.

ATTY. BLESSIE ROSE L. CARPENA

Notary Public
Until December 2016
Roll of Attorney No. 64719
PTR No. 2768430; 02/01/16 Santa Rosa, Laguna
IBP No. 1027161; 02/02/16 Laguna
MCLE Comp V-0021577