Affidavit of Lost Document

State of [Your State], County of [Your County]

INTRODUCTION

I, [Your Name], residing at [Your Address], do solemnly declare and affirm under penalty of perjury that the following statements are true and correct to the best of my knowledge and belief:

STATEMENT OF FACTS

1. On [Date], I discovered that my passport, bearing passport number [Passport Number], issued on [Date of Issue] by [Issuing Authority], has been lost.

2. I have searched thoroughly and made diligent efforts to locate the said passport, but it remains unaccounted for.

3. I understand the seriousness and implications of losing a passport, and I have taken all necessary steps to report its loss to the relevant authorities.

4. I have not knowingly lent, transferred, or disposed of the passport to any individual or entity since its issuance.

5. I hereby undertake to inform the appropriate authorities immediately should I come across the missing passport or have any reason to believe it has been found.

6. I request the issuance of a replacement passport to facilitate my travel and identification needs.

I swear under oath that the foregoing statements are true and correct, and I am aware that any false statements made herein are punishable by law.

[Your Name]

[Date]

---

Subscribed and sworn to before me this [Date] by [Your Name].

Witness my hand and official seal:

[Notary Public Name]

Commission Expiration Date: [Date]

My Commission Number: [Commission Number]

[Seal or Stamp]

Affidavit Templates @ Template.net