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, bond, promissory note, 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.

Section 1 — Lost Document Information

Document Type *

Lost a U.S. passport? Report it with State Department Form DS-64 instead.

Section 2 — Circumstances of Loss

Date Document Was Lost or Discovered Missing *

Last Known Location of the Document *

Brief Description of How the Document Was Lost *

0/1000

I have not sold, transferred, pledged, or assigned this document. *

If it was transferred, an affidavit of loss isn't the right document.

Section 3 — Affiant Information (Person Signing)

Full Legal Name *

Relationship to the Lost Document *

Street Address *

City *

State *

ZIP Code *

Section 4 — Sworn Statement

Pre-populated statement — updates as you fill the form

I, [Affiant Name], of [Street Address], [City], [State] [ZIP Code], being first duly sworn, state as follows:

1.
I am the lawful owner of the following [Document Type]:
Document Type:[Document Type]
2.
On or about [Date of Loss], the document was lost or could not be located. Its last known location was: [Last Known Location].
3.
The circumstances of the loss are as follows: [Circumstances of Loss].
4.
I have made a diligent search for the document and have been unable to find it.
5.
The document has not been sold, transferred, pledged, assigned, or otherwise disposed of, and to my knowledge no other person has any right or interest in it.
6.
If the original document is found, I will not negotiate, transfer, or otherwise use it, and I will promptly return it to the issuer or other party relying on this affidavit for cancellation.
7.
I agree to indemnify and hold harmless the issuer of the document, and any party that relies on this affidavit, from any loss, claim, or expense arising from the original document later being found or presented.
8.
I make this affidavit to establish the loss of the document and to request its replacement or other appropriate relief.
9.
I declare under penalty of perjury that the foregoing is true and correct.

Section 5 — Signature & Notary

Jurat

State of ____________________ County of ____________________

Subscribed and sworn to (or affirmed) before me on this ____ day of ______________, 20____, by ____________________.

Notary Public Signature: ____________________

Printed Name: ____________________

Commission No. (if any): ____________________

My Commission Expires: ____________________

[Notary Seal]

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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 diligent search for the item and have not found it.
4Confirm that you have not sold, transferred, pledged, or assigned the item to any other party.
5Review the promises to return the original if it is found and to indemnify the issuer, then sign the completed form under penalty of perjury before a notary public and submit it to the institution that issued the original document.

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What Is an Affidavit of Loss?

An Affidavit of Loss is a notarized statement in which the owner of a document or instrument, or someone signing on the owner's behalf, declares under penalty of perjury that the item has been lost, stolen, or destroyed, and that they have made a diligent search for it without finding it. It is most commonly used for negotiable instruments (checks, promissory notes), stock certificates, corporate and municipal bonds, titles, and other irreplaceable documents. Lost U.S. savings bonds are the exception: the Treasury replaces those through FS Form 1048, not a general affidavit of loss. By signing the affidavit, the signer swears that the item has not been sold, transferred, pledged, or assigned, promises not to use the original and to return it for cancellation if it is ever found, and agrees to indemnify the issuer and anyone relying on the affidavit if the original 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. Transfer agents for publicly traded companies, and banks, often require their own lost-instrument form and may require a surety bond, so check with them before you sign.

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 sold, transferred, pledged, or assigned, and by agreeing to return the original if found and to indemnify the issuer, the signer 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 corporate or municipal bond certificate has been lost or destroyed
✓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

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