Affidavit of Loss

What is an affidavit of loss sample?

An affidavit of loss sample is a formally sworn written statement used to confirm that a specific item or document has been lost. This document serves as legal proof of a document’s or object’s loss that could be presented to banking institutions, immigration authorities, federal agencies, corporate registers, etc.

This document could be created only by an affiant. This is an individual of 18 years old or more who, under penalty of perjury, swears that he or she lost a certain official document or object. It also means that an affiant could be an official holder of a document or an owner of an object. For example, in the case of an affidavit of loss stock certificate, only a company’s stockholder has a right to prepare this affidavit.

You may need this document in various situations:

• to replace the loss of the original document;
• to update information in corporate registers (e.g., affidavit of loss stock certificate);
• to prevent fraudulent intention of third parties aimed at misusing lost documents.

How to draft an affidavit of loss template?

Neither federal nor state laws define a sample format of affidavit of loss. At the same time, there are a number of mandatory elements every affidavit should include. Those elements are

Details of the Affiant

The introduction for an affidavit of loss shall include identification details of an affiant:

• full name and residential address;
• date, town/city, and state of birth;
• contact phone number; and
• social security number.

Details of the Lost Document or Object

A well-written template should clearly describe the document or object a person lost.

If it is an object, an affiant must state its size, weight, color, form, shape, and any other additional characteristics that help to identify the object in question.

When it comes to the loss of official documents, in that case other information must be given. For example, for an affidavit of loss of passport, an affiant shall state the passport number, date of issuance, and the name of a state authority that issued a passport (which is optional). If an affiant creates an affidavit of loss driving license, not only the ID number and date of issuance should be given, but also the name of the state where such a license was produced/approved.

Circumstances of Loss

The text of an affidavit has to explain how the loss occurred, including:

• approximate date when the loss occurred;
• potential circumstances due to which loss occurred;
• if an affiant makes attempts to replace it (applicable only for a loss of official documents).

Statement of Truth

A well-drafted affidavit of loss template must contain the following affiant’s statements and representations that:

• the information provided in the document is accurate and true;
• the provision of any false information is punishable by applicable federal and state laws.

Apart from that, an affiant must also present any kind of an identity document to a notary in order to prove their identity.

Signature

Once an affidavit of loss template is ready, an affiant shall carefully read it. If all the provided information is accurate, an affiant must put their signature at the end of the document.

An affidavit could not be signed by an affiant’s representative acting as his or her power of attorney. This type of legal document is a personal document. Thus, it is not possible for a representative to act on an affiant’s behalf.

Notarization of the Document

The last but not less important step to make an affidavit of loss a valid legal document is its notarization. You can pick up any notary of your choice in a county of a state where you currently reside. Please note that notaries may charge additional fees for the notarization of this document.

It is important to remember that a notary confirms only the fact that an affiant put their signature on the document. In fact, a notary does not confirm the authenticity or correctness of the information provided in the document.

How to customize an affidavit template at FasterDraft?

To get a legal document suitable for your particular circumstances, follow the steps below:

1. Click the “Create Document” button.
2. Answer simple questions in the form.
3. Select a document’s format—affidavit of loss template PDF or Word.
4. Make a payment.
5. E-sign, download, print, and notarize the document.