Affidavit of Loss (General)
Swear under oath that a document or item of any kind — a stock certificate, diploma, receipt, employee badge, title, or promissory note — has been lost and cannot be found despite a diligent search. Issuers, registrars, transfer agents, and employers commonly require this all-purpose affidavit before issuing a duplicate or replacement.
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Download Blank TemplateAffidavit of Loss (General) Affidavit — Frequently Asked Questions
What is an affidavit of loss and when do I need one?
An affidavit of loss is a notarized sworn statement declaring that a document or item — such as a stock certificate, diploma, title, or promissory note — was lost, stolen, or destroyed and cannot be found. Issuers require it before releasing a duplicate, both to document the loss and to protect themselves if the original ever resurfaces.
Do I need a bond with an affidavit of loss for a stock certificate?
Often, yes. For lost stock certificates and some other negotiable instruments, transfer agents typically require an indemnity bond — usually costing a small percentage of the security's value — in addition to the notarized affidavit of loss, so the company is protected if the original certificate is later presented by someone else.
How do I make a affidavit of loss (general) affidavit legally valid?
Fill in the affidavit of loss (general) affidavit, print it, and sign it in front of a Notary Public — do not sign beforehand. Bring a valid government-issued photo ID. Notaries are available at UPS Stores, banks, law offices, courthouses, and through online notarization services, and fees typically range from $2 to $25 per signature depending on your state.
Is this affidavit of loss (general) affidavit template free?
Yes. You can generate a completed affidavit of loss (general) affidavit PDF or download a blank printable template completely free, with no sign-up required. Your information is used only to generate the document and is not stored after the PDF is created.