Affidavit of Loss Samples & Templates

Have you ever tried losing an important document, such as your ID card or ATM card? Lucky for me, I haven’t, but I know a couple of people who have experienced this kind of situation. They went through a lot of hassle just to be able to have it replaced. It’s a total disruption of their daily activities and a complete inconvenience. The only good thing about being in this situation is you only need to acquire one important document such as an affidavit of loss to be able to get a replacement for your lost ID card or ATM card. You may also see affidavit of support forms.

In this article are useful sample affidavit of loss that you can view, download, and use as reference for your needs. So that you will also know more about what an affidavit of loss is, we have included here things that you would need, like when it is used, how to get one, how much you need to pay for to get one, and other important information. With all these samples and all the information that we have put together in one article, you are sure to get your job done. Check them out below!

Download Affidavit of Loss Bundle

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Affidavit of Loss Driver’s License

STATE OF [State]
COUNTY OF [County]

I, [Your Full Name], of legal age, having been duly sworn in accordance with law, do hereby depose and state:

1. That I am a legal resident of [Your Complete Address], within the jurisdiction of [City/Town], [State].
2. That I was previously in possession of my driver’s license issued by the [State] Department of Motor Vehicles, bearing License No. [Your Driver’s License Number].
3. That on or about [Date of Loss], in the vicinity of [Location of Loss], I discovered that my said driver’s license was missing and despite diligent efforts to locate the same, it could not be found and is now considered lost.
4. That I have neither mortgaged nor pledged the said driver’s license to any person or entity and that the loss was not caused by any fraudulent act or illegal transaction on my part.
5. That the said driver’s license is being reported lost to prevent its fraudulent use or misuse by any unauthorized individual.
6. That I am executing this affidavit to attest to the truth of the foregoing facts and to request the issuance of a duplicate driver’s license from the [State] Department of Motor Vehicles, in lieu of the one that was lost.
7. That I am executing this affidavit to indemnify the [State] Department of Motor Vehicles from any liability or claim that may arise from the issuance of a duplicate license to me.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of __________, 20 at [City/Town], [State].

[Your Full Name]
[Your Signature]

SUBSCRIBED AND SWORN to before me this ___ day of __________, 20, by [Your Full Name], who is personally known to me or who has presented _____________ as identification.

Notary Public:
[Notary Public’s Name]
[Seal]
Commission Number: _________
My Commission Expires: _________

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Affidavit of Loss Cost

STATE OF __________
COUNTY OF _________

I, [Affiant’s Full Name], of legal age, [Job Title/Profession], and a resident of [Address], [City], [State], Zip Code [Zip Code], being duly sworn in accordance with the law, do hereby depose and state:

1. Identification: That I am the lawful owner/holder of [Describe the Item or Document Lost, including any identifying information such as Document Number, Issuance Date, and Issuing Authority, if applicable].
2. Circumstances of Loss: That on [Date of Loss], in the vicinity of [Location of Loss], I discovered that the aforementioned item was missing. Despite diligent efforts to locate the item, including [briefly describe any steps taken to find the item], it has not been recovered.
3. Non-Recovery Declaration: That to the best of my knowledge and belief, the said item has not come into the possession of any person whomsoever, and its whereabouts remain unknown.
4. Need for Affidavit: That this Affidavit is being executed for the purpose of declaring the loss of the said item and to support my application for a replacement of the same from the relevant authority.
5. Indemnification Clause: That I hereby agree to indemnify and hold harmless any entity issuing the replacement from any claim, demand, suit, action, or other proceedings that may arise as a result of the issuance of such replacement.
6. Truthfulness Statement: That I execute this Affidavit to attest to the truth of the aforestated facts and in compliance with the requirements for the re-issuance of the lost item.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this [Day] day of [Month], [Year].

[Affiant’s Signature]

SUBSCRIBED AND SWORN to before me this [Day] day of [Month], [Year], by [Affiant’s Full Name], who is personally known to me or who has produced [Type of Identification] as identification.

[SEAL]

Notary Public
My Commission Expires: ______________

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Affidavit of Loss School ID

STATE OF [Your State]
COUNTY OF [Your County]

I, [Your Full Name], of legal age, with residence at [Your Full Address], after being duly sworn in accordance with law, hereby depose and state:

1. That I am a currently enrolled student at [Name of School], located at [School Address], and was issued an Identification Card (ID) bearing the number [Your School ID Number].
2. That on or about [Date of Loss], I discovered that my said School Identification Card was missing and despite diligent search and efforts to locate the same, said ID could not be found and is now considered lost.
3. That I have not mortgaged, pledged, sold, or in any manner disposed of the said ID to any person or entity.
4. That I am executing this Affidavit to attest to the truth of the foregoing facts and to request the issuance of a replacement for my lost School Identification Card from [Name of School], for identification and record purposes.
5. That I hereby undertake to surrender the said lost Identification Card to [Name of School] immediately, should the same be found or recovered in the future.

IN WITNESS WHEREOF, I have hereunto set my hand this ___ day of [Month], [Year], at [City/County], [State].

[Your Signature]

[Your Printed Name]

Subscribed and sworn to before me this ___ day of [Month], [Year], at [Location], by [Your Full Name] who is personally known to me or who has presented [Type of Identification] as identification.

Notary Public:

[Signature of Notary Public]
[Printed Name of Notary Public]
Commission Number: [Commission Number]
My Commission Expires: [Expiration Date]

[SEAL]

Notary Public for the State of [Your State]
County of [Your County]

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Affidavit of Loss Sim Card

STATE OF [State Name]
COUNTY OF [County Name]

Before me, the undersigned authority, on this day personally appeared [Your Full Name], who being duly sworn, deposes and says:

1. Identity and Capacity: My name is [Your Full Name], I am of legal age, with a residence at [Your Address, City, State, Zip Code]. I am competent to make this affidavit and have personal knowledge of the facts stated herein.
2. Description of Lost Property: I am the lawful owner of a SIM card, with the number [Your Sim Card Number], issued by [Name of the Telecom Company].
3. Circumstances of Loss: That on or about [Date of Loss], I discovered that my SIM card was missing. Despite diligent search and effort, I have been unable to recover said SIM card. I believe it to be lost and not recoverable.
4. Purpose of Affidavit: This affidavit is executed for the purpose of declaring the loss of the aforementioned SIM card and to request [Name of the Telecom Company] for a replacement of the same.
5. No Fraudulent Intent: I declare that the SIM card was lost under the circumstances mentioned and that there is no fraudulent intent in this declaration.
6. Indemnity: I hereby agree to indemnify and hold harmless [Name of the Telecom Company] from any claims, damages, and demands that may arise from or in connection with the issuance of a new SIM card to replace the lost one.
7. Governing Law: This affidavit is made in accordance with the laws of the State of [State Name] and shall be used for the purpose stated herein.

Further Affiant sayeth naught.

[Signature Line for Affiant]

[Your Full Name]

Subscribed and sworn to (or affirmed) before me on this the ___ day of ________, 20, by [Your Full Name], proved to me on the basis of satisfactory evidence to be the person who appeared before me.

[Signature Line for Notary Public]

Notary Public

My Commission Expires: ______________

[SEAL]

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Browse More Templates On Affidavit of Loss

Payment for Affidavit of Loss Template

Free Affidavit of Loss Template

General Affidavit of Loss Template

Tips For Writing an Affidavit of Loss

Writing an affidavit of loss involves creating a formal, sworn statement declaring the loss of an important document or item, such as a passport, identification card, SIM card, or valuable paper. This legal document is used to attest to the loss and can be critical for obtaining replacements or for legal records. Here are some tips for writing an effective affidavit of loss:

1. Use a Formal Tone: An affidavit is a legal document, so maintain a formal and professional tone throughout the text.
2. Include Your Personal Information: Start with your full name, age, address, and occupation to identify yourself clearly as the affiant (the person making the affidavit).
3. State the Document or Item Lost: Clearly identify the lost item or document, including any identifying details like account numbers, serial numbers, or issuance dates.
4. Detail the Circumstances of the Loss: Describe how, when, and where you noticed the item was missing. Include dates and locations, and explain the efforts made to find the lost item.
5. Declare Your Ownership: Affirm that you were the lawful owner of the lost item or document at the time it went missing.
6. Purpose of the Affidavit: Specify why you are making the affidavit, such as to apply for a replacement document or to record the loss officially.
7. No Fraudulent Intent Statement: Include a declaration that the affidavit is made in good faith and without any fraudulent intentions.
8. Indemnification Clause: If applicable, include a statement where you agree to indemnify the relevant parties (e.g., a company or institution) against any claims or damages that might arise from the issuance of a replacement for the lost item.
9. Jurisdiction: Mention that the affidavit is subject to the laws of the state or country where it is being made, indicating your awareness of legal responsibilities.
10. Signature and Notarization: End with a sample statement that you swear or affirm the truthfulness of the affidavit’s contents under penalty of perjury, followed by your signature. The affidavit must be signed in the presence of a notary public, who will also sign and seal the document.
11. Proofread: Before finalizing, carefully proofread the affidavit to correct any errors in spelling, grammar, or factual information. Accuracy is crucial in legal documents.
12. Consult a Template or Professional: If available, use a template or consult a legal professional to ensure the affidavit meets all necessary legal requirements and standards.

Remember, an affidavit of loss is a serious document that serves as your sworn statement regarding the disappearance of something valuable or important. It’s essential to be truthful and precise in your descriptions and statements.

Sample Passbook Affidavit of Loss Template

Affidavit of Loss of Passport Outline

Affidavit of Loss for Government Use Template

Basic Affidavit of Loss for Health Insurance Plan Template

Importance of Affidavit of Loss

The Affidavit of Loss is a critical legal document with significant importance in various situations, primarily serving to formally declare the loss of important items such as documents, identification cards, certificates, or personal property. Here are key reasons why an Affidavit of Loss is important:

1. Legal Requirement for Replacement: It often serves as a necessary step to obtain a replacement for the lost item. Institutions and agencies typically require an affidavit to process the issuance of a new document or item, ensuring due diligence is observed.
2. Fraud Prevention: By officially documenting the loss, it helps in mitigating potential fraud or misuse of the lost items. For instance, if an ID or credit card is lost, the affidavit helps in protecting the identity and financial resources of the affidavit’s issuer from unauthorized use.
3. Official Record: It provides a formal record of the circumstances surrounding the loss. This can be crucial for legal, personal, or business records, establishing a timeline and details that may be referenced in future disputes or claims.
4. Responsibility and Ownership: The affidavit demonstrates the owner’s proactive steps in acknowledging and reporting the loss. This can be important in cases where ownership needs to be proved or disputed.
5. Assurance to Third Parties: For businesses or individuals who may be affected by the loss (such as banks, employers, or government agencies), the affidavit offers assurance that the matter is being handled appropriately, reducing liability and setting a course for corrective action.
6. Supporting Document in Legal Actions: In instances where legal action is necessary (either as a result of the loss or in efforts to recover the lost item), the affidavit serves as a supporting document, detailing the loss’s specifics and the affiant’s statement under oath.
7. Psychological Closure: On a personal level, taking the formal step to document the loss can provide the affected individual with a sense of action and closure, allowing them to move forward and address the loss’s practical implications.
8. Clarity and Transparency: It helps in providing clarity and transparency about the situation to all involved parties, which is particularly important in business or legal contexts where the precise details of the loss may impact decision-making or outcomes.

In summary, an Affidavit of Loss is a pivotal document that facilitates the replacement process, aids in fraud prevention, and serves as an official record of the loss. Its legal and practical significance makes it an essential tool in managing the consequences of lost items or documents effectively.

Affidavit Due to Loss of Wallet Example

What Is an Affidavit of Loss?

Some of us might have heard of an affidavit of loss once or twice in our lives. It’s what the human resources department tells us to get to be able to have our company IDs replaced or to get that replacement government ID. All we know is that it is a piece of paper that we give to get a replacement. But what really is an affidavit of loss? You may also affidavit of support letters.

Let’s breakdown the words affidavit of loss. Affidavit is defined is a sworn statement or a statement that is written and confirmed by doing an oath. An affidavit is also a document that is presented in court to serve as proof or evidence. The word loss, on the other hand, is a very familiar word that we use often that means that something or someone is missing. Now if you put them together, an affidavit of loss would come to mean a legal written document that says something about the physical loss of another important document. An affidavit of loss serves as proof that you no longer have that particular document because it was either stolen, destroyed, or lost. You will be needing this legal letter or document in order to replace lost or stolen credit cards, driver’s license, and many more.

If you wish to issue an affidavit other than an affidavit of loss, you may want to use free affidavit forms to make your task easy. These forms will definitely help you with any of your legal dealings.

What Is an Affidavit of Loss Used For?

Whenever you lose something such as an important document, you would want to get it replaced. I would feel that way too. If the reason for getting a replacement is because it was either stolen, damaged, or lost, then there is no doubt that you will need an affidavit of loss. Below we have listed a a couple of uses of an affidavit of loss. You may also see affidavit forms.

• An affidavit of loss is used to declare that you have lost a particular thing. Some people just want to have a lot of duplicates of original documents or IDs so what they do is they claim that they lost the one that they have in order to get another one. And that leaves them with two or more copies of the same document. Getting an affidavit of loss would make you give a sworn statement example that the particular document is really no longer with you. You would face consequences if you lie.
• An affidavit of loss is used as proof that a particular document is no longer with you or to indicate that a certain record is truly gone.
• An affidavit of loss is as used as proof of your ownership of something. Old documents often get misplaced. Some documents are torn or already faded when we come to retrieve them. These documents need to be replaced with a fresh copy, and in order to do that, you will need to file for an affidavit of loss. You may use the appropriate sworn affidavit forms for this.
• An affidavit of loss is required when you need to have a legal document replaced.
• An affidavit of loss is used for identity theft where the identification cards are either lost or stolen. This is a serious matter that cannot be and should not be overlooked by anybody. Getting an affidavit of loss immediately after the said incident will prevent further damages that can be caused by identity theft.
• An affidavit of loss is used when particular legal documents are out of hand and not available to be presented during court proceedings.
• An affidavit of loss is used when proof or solid evidences that are hardbound may not be presented by an identity, whether it be for personal or corporate usages.

If you are not sure if it’s an affidavit of loss you need to file, you can browse through other sample affidavits, like sample affidavit of support letter and sample blank affidavit forms.

The List of Things That Usually Require an Affidavit of Loss

Now that you know what an affidavit of loss is and what is it used for, it will surely be pretty easy for you to identify the things that require an affidavit of loss. Of course, we wouldn’t be giving you a hard time about that so we are listing the things that usually require an affidavit of loss. Check them out below. You can also see affidavit of support samples.

• Lost, stolen, damaged or broken identification cards like company ID, government issued IDs, passport, health insurance card, debit card and credit cards, driver’s license, membership cards and ATMs, to name a few.
• Lost, stolen, or worn out documents like sample certificates of title for your home and your vehicle, lot titles, business permits, business titles, report cards, seminar certificates, and many more.
• Certain documents that are to be used as proof or evidence in court but cannot be presented because it’s hardbound or part of a set of a file of other important documents
• Lost or stolen insurance certificates
• Lost or stolen passbook
• Lost or stolen contracts

Anything that can be lost may require an affidavit of loss. There are institutions or organizations that will really require you to get an affidavit of loss for anything that has been lost or stolen, especially if you are requesting to have it replaced. Also, keep in mind that there are institutions or organizations that do not require it. It is best that you ask them about the standard operating procedure that they follow in this kind of situation.

Who Is Authorized to Issue an Affidavit of Loss?

Only certain professionals can issue such document as it should be something written and confirmed by an oath, more like a sample sworn statement. So if you would be getting an affidavit of loss, make sure that it is issued by a registered attorney. It is only deemed valid if a real attorney issues, signs, and does whatever to the said document.

Affidavit of Loss Note Template

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Affidavit of Loss for Verification Format

Affidavit of Loss for Promissory Note Template

Affidavit of Ownership and Loss with Undertaking Template

Affidavit Lost Note for Individual Lender Template

Sample Affidavit Concerning Lost Check Template

Lost Receipt/Invoice Affidavit Template

Where Can You Get an Affidavit of Loss?

An affidavit of loss is usually issued inside a registered attorney’s office where they sign and seal it. They will also ask you to affix your signature somewhere for record keeping purposes. The location for where the sample affidavit signing and issuance depends on what country, city, or province you had it filed. An affidavit of loss does not always have to be filed in the city or nearby areas as there are some lawyers who have their own firms located somewhere else that may not be near any government establishments.

How Much Will It Cost You to Get an Affidavit of Loss?

The price you have to pay for filing for an affidavit of loss depends on where you got them and who issued them. Government lawyers working in government offices often issue an affidavit of loss without having to pay for anything. However, there are also some who say that they paid a certain amount for the dry seal and this and that. If you go to private lawyers, there will really be a fee, so you should prepare yourself for the price you need to pay as it may be costly. You may also see blank affidavit forms.

No matter where you plan to file for an affidavit of loss, it is very important that you consider whether the lawyer who issued it is legit because this will affect the document. A fake lawyer will surely produce a fake document and you know that you don’t want that. Not only will you be paying for something that is useless, you will also get yourself into legal problems. Very serious legal problems!

What Details Should You See in an Affidavit of Loss?

Have you seen an affidavit of loss before? An affidavit of loss is just a simple document that includes only the necessary and important things that completes the document. The important details that you can see in an affidavit of loss are as follows: You may also see affidavit forms in pdf.

• The date and place where the affidavit of loss was issued.
• The name of the person who filed for the affidavit of loss.
• The complete address of the person who filed for the affidavit of loss.
• The exact reason for filing the affidavit of loss.
• The date and place where the affidavit was filed.
• The signature and license number of the issuing attorney.
• Stamp or dry seal.

Some affidavit of loss may contain more details than the ones provided above. That is okay as long as the document is valid or credible, just like that of sample notary statements. An affidavit of loss might be very different from that of a contract, but they are handled the same way as you would with a legal contact.

How to Get an Affidavit of Loss

Before you get an affidavit of loss, you first need to know the things that you will need to bring. This is to save you time and effort instead of going back and forth but still not accomplishing anything. Imagine being able to save your energy if you only know what to do. Doing research and some know-how about how to get an affidavit of loss will surely help you. We want to help you as much as we can, so we will be providing you with easy to follow steps on how you can get an affidavit of loss. You may also see sworn affidavit forms.

1.Do Your Research.

This should be the very first thing that you should do. There are a lot of benefits for doing your research and doing them properly. Through research you will be able to find out the requirement documents needed to be able to file an affidavit of loss and other stuff you need to do. How hard can that be? It’s harder if you weren’t able to do anything at all with all your effort and the time you spent to go to the attorney’s office.

2.Prepare the Requirements.

You wouldn’t want to go battle unarmed as you will just be killed, unless you’re the main character in the movie. Requirements are very important because they serve as proof of your identity and also as legal documents that the firm would keep in their records.

3.Look for Public Attorney’s Office

You don’t have to go far to get to the nearest public attorney’s office. You can go the public attorney’s office in your town or state. There is actually no need for you to travel to the next state. All you need to do is look it up before you actually go there. If not, you can call them to inquire about filing an affidavit of loss.

4.Check if you Need to Set an Appointment

Get a hold of the contact information of the office you want to go to. Contact them a day or two before you head to their office and ask if you need to set an appointment to be entertained. Most offices don’t require this, but it’s better to be prepared than sorry.

5.Go to the Public Attorney’s Office.

When you get to the public attorney’s office, there will be a secretary whom you can ask help with what you need to do. Wait for her instructions as she is the only one who can help you there, probably.

6.Fill out the Application Form.

The secretary will provide you with an application form where you need to put in the required information needed by the lawyer to create the affidavit of loss. Don’t worry, there are no problem solving questions and definitely no calculus computations involved. It would just be between you and the details of the lost item. Just don’t be afraid to ask about any questions if there is something you’re not sure about.

7.Wait for the Attorney to hand you the Document.

Once you’re done filling out the basic application form, you may be asked by the secretary to wait before you get to see the lawyer in the office. Just wait for their instruction and make sure to double-check if the details of the affidavit are correct before it gets finalized and signed. So the lawyer may ask you to sign the document together with a witness, usually the secretary, and then add a stamp or some seal. Then they’ll hand it over to you. The secretary is usually the one whom you would hand in the payment, if there is a fee for it.

8.Answer a Feedback Form

Lastly, they may ask you to answer a feedback form, which will take just a couple minutes of your time depending on how fast you can read and answer it. After that you should be good to go.

How to Make Your Own Affidavit of Loss

Here is another thing you might be interested about. If you need and affidavit of loss, but not one that can be acquired from the public attorney’s office, then the steps that we have created below will definitely be of great help to you. It could be for your school project or if you work in a public attorney’s office. First up, you’ll need enough knowledge about what an affidavit of loss is. This article is exactly what you need. Reread through the helpful information we have provided here and browse through all of the samples that we have included. You may even download all of them if you want and they are all for free! You may also see power of attorney forms.

Need templates? We also have that covered. You can use the samples as your own. Just edit them according to how it will be used. If you don’t find what you are looking for, then you can check other samples that we have on our website. Make sure that all the necessary and important details are in your affidavit of loss, that way its legality or credibility won’t be questioned.

Review everything that has been written. Check for any spelling or grammar errors, and keep in mind that there should be no erasures on the document. If you have all the steps done, the document can now be finalized. If you are authorized to issue the affidavit of loss then you will be the one to sign it and put a stamp or dry seal to it. If you are not authorized to issue the affidavit of loss, then you will need to give it to someone who is authorized. You can also see legal invoice samples.