Affidavit of Lost Stock Certificate

$25.00
This is a form of affidavit where a shareholder declares that he or she has lost his or her stock certificate, wishes to get a replacement certificate, and agrees to defend, indemnify, and hold harmless the company issuing a new certificate.

Format: word_icon Microsoft Word

Affidavit of Lost Stock Certificate  

The undersigned hereby declares under penalty of perjury as follows:

1. The undersigned is the owner of a total of _________ shares of the Common Stock of ______________________, Inc., a ____________ corporation (the “Company”).

2. The undersigned has examined his, her or its records and, after diligent search, is unable to find the certificate or certificates representing such shares (the “Certificates”) and believes that the Certificates were lost.

3. The undersigned has not...

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