What happens after I submit an Affidavit of Loss?

Typically, you submit the notarized affidavit (and sometimes an indemnity bond) to the institution that issued the original document. The institution will review your claim and, if approved, issue a replacement or allow you to proceed without the original. Processing times vary by institution — a DMV replacement title may take a few weeks, while a stock certificate replacement may take longer.

Do I need an indemnity bond with an Affidavit of Loss?

Many institutions — particularly for high-value instruments like stock certificates and cashier's checks — require both an Affidavit of Loss and a surety indemnity bond. The bond protects the institution if the original document later appears and is presented. Some institutions waive the bond requirement for lower-value items or long-standing customers, so it is worth asking about the threshold.

Is an Affidavit of Loss the same as reporting something stolen?

No. An Affidavit of Loss covers lost, destroyed, or stolen items, but it is not a police report. If you believe the item was stolen, you may also want to file a police report separately. Some institutions require a police report in addition to the affidavit for items reported as stolen, particularly for higher-value instruments or bearer instruments that could easily be fraudulently presented.

What is an indemnity bond and do I need one?

An indemnity bond (also called a lost instrument bond or surety bond) is a financial guarantee purchased from a bonding company that protects the issuing institution against losses if the original lost document later surfaces and is redeemed. Not all lost instrument claims require a bond — many institutions waive the requirement for small amounts — but for high-value items like cashier's checks or large stock certificates, a bond is commonly required alongside the Affidavit of Loss.

Can I use this form to replace a lost vehicle title?

For a lost vehicle title, you typically need to contact your state's DMV directly and use their specific replacement title application form, which often includes or accompanies an affidavit of loss. While our free form can document the circumstances of the loss, the DMV may require their own standardized form as well. Check your state DMV's website for exact replacement title procedures and required documentation.

Free Affidavit of Loss Form

An Affidavit of Loss is a sworn statement reporting that an important document or instrument — such as a check, stock certificate, promissory note, savings bond, or title — has been lost, destroyed, or stolen. It is typically required before a replacement can be issued.

Complete the Form

Fill in the fields below, then download your completed affidavit.

Affidavit of Loss

Fill in the fields below to generate your form.

Affiant Information

Full Legal Name *

Date of Birth

Street Address *

City *

State *

Sworn Statement

Statement of Facts *

I swear or affirm that the above information is true and correct to the best of my knowledge.

Signature

Date of Signature *

Notary Acknowledgment

State of _________________________ County of _________________________

Subscribed and sworn to before me on this _____ day of _______________, 20_____.

Notary Public: __________________________ My Commission Expires: __________________

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How to Complete This Form

1Identify the lost item by type, number, issuer, and approximate value or date of issuance.
2Describe the circumstances under which the item was lost, destroyed, or stolen.
3State that you have made a reasonable search for the item and have not found it.
4Confirm that you have not transferred, endorsed, or assigned the item to any other party.
5Sign the completed form before a notary public, then submit it to the institution that issued the original document.

What Is an Affidavit of Loss?

An Affidavit of Loss is a notarized statement in which the holder of a document or instrument declares that the item has been lost, stolen, or destroyed, and that they have made a reasonable search for it. It is most commonly used for negotiable instruments (checks, promissory notes), stock certificates, savings bonds, titles, and other irreplaceable documents. By signing the affidavit, the holder swears that they have not transferred the lost item to a third party, and that they accept liability if the original item later surfaces and is presented for payment or redemption. Issuing institutions often require both an Affidavit of Loss and an indemnity bond before issuing a replacement.

An affidavit of loss form typically covers lost or destroyed negotiable instruments, securities, and title documents. The specific language of the affidavit matters because it protects the issuing institution — by swearing that the item has not been transferred or endorsed, the holder takes on responsibility if the original later surfaces. Filling out an affidavit of loss form accurately helps ensure that the issuing institution is protected and that your replacement request will be processed.

An affidavit of loss template is a practical starting point, but be aware that the institution you submit it to may have their own required form. Banks, DMVs, and stock transfer agents often have proprietary affidavit of loss forms, and some will not accept a third-party version. Always check with the institution first. When their own form is not available or not required, a notarized free-form affidavit of loss is generally accepted.

When Do You Need an Affidavit of Loss?

✓A personal or cashier's check has been lost or destroyed
✓A stock certificate cannot be located and you need a replacement
✓A U.S. savings bond has been lost or stolen
✓A vehicle title has been misplaced and you need a replacement from the DMV
✓A promissory note or mortgage note cannot be located
✓A financial institution requires documentation before issuing a stop payment
✓You need to claim a savings bond after losing the original

Notarization Required

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