Affidavit of Lost Shares Certificate

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About this template
An Affidavit of Lost Shares Certificate under USA law is a legal document that is used to declare the loss or misplacement of a stock certificate issued by a company. This template is designed to provide a standardized format for individuals or shareholders who have lost their physical stock certificates and need to swear a legally binding statement affirming the loss.

The affidavit includes key information such as the individual's personal details, details about the lost stock certificate including the company name, certificate number, and the number of shares held. The template also provides a space for the affiant (the person making the affidavit) to explain the circumstances surrounding the loss and any efforts made to locate or recover the certificate.

By executing this document, the affiant is affirming under penalty of perjury that they have lost the original stock certificate and that they will not make any fraudulent claims or transfers related to the lost shares. The completed affidavit can then be used as supporting documentation to initiate the necessary procedures to replace the lost certificate and ensure that any future transfers of the shares are properly recorded.

It's important to note that the specific contents of the affidavit may vary depending on the requirements of the issuing company or the relevant state laws. This template, however, serves as a starting point for individuals who need to create a sworn statement in accordance with USA law when facing the loss of a stock certificate.
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affidavit-of-lost-shares-certificate.docx

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