REPUBLIC OF THE PHILIPPINES )

CITY OF TARLAC ) S.S.

AFFIDAVIT OF TERMINATION

That I, _____________________, of legal age, Filipino, and a resident of

_______________________________, after having been duly sworn to in accordance with law,
do hereby depose and state the following:

1. I have a business named ______________________ registered before BIR, SSS,

Philhealth and Pag-ibig;
2. That on ___________________, I decided to terminate my employee named
_____________________, with SSS Number _________________, that is registered on
SSS as my employee;

3. That since the said date, I did not employ any employees therefore I handled the business
by myself;

4. I execute this Affidavit to certify or attest to the truth of the foregoing facts and for
whatever legal purpose that this Affidavit may serve.

IN WITNESS WHEREOF, I have hereunto set my hand this _____________ day of

______________ at Tarlac City.

________________________
Affiant
ID No.: _______________

SUBSCRIBED AND SWORN to before me this ________ day of ______________ at

Tarlac City.

Doc. No. ______;

Page No. ______;
Book No. ______;
Series of 2019.