Free Notary Affidavit For Lost Certificate Template
Notary Affidavit For Lost Certificate
I. Introduction
I, [Your Name], a duly commissioned and qualified Notary Public within and for the [Your City], [Your State], do hereby certify that on this [Date] day of [Month], [Year], before me, personally appeared [Name of Affiant], known to me to be the same person whose name is subscribed to the foregoing instrument, and acknowledged to me that they executed the same for the purposes therein contained.
II. Affidavit of Lost Certificate
A. Affiant Details
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Full Name: [Name of Affiant]
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Address: [Affiant's Address]
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Contact Number: [Affiant's Phone Number]
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Email Address: [Affiant's Email Address]
B. Statement of Loss
I, [Name of Affiant], hereby declare under penalty of perjury that I am the lawful owner of the [Type of Certificate], issued by [Issuing Authority] on [Date of Issuance], bearing certificate number [Certificate Number]. Unfortunately, due to circumstances beyond my control, the aforementioned certificate has been lost. I have made a diligent search for the certificate, but it could not be found.
C. Circumstances of Loss
The loss of the certificate occurred under the following circumstances:
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On [Date], [Name] misplaced the certificate during a relocation process. The certificate, which was securely stored in a labeled envelope, inadvertently became separated from other important documents during the packing and unpacking of household items. Despite exhaustive searches of the residence and the moving boxes, the certificate has not been located.
D. Replacement Request
I am officially putting forth a request to the issuing authority, asking if they would be kind enough to provide a replacement for the certificate that I have unfortunately lost.
III. Notary Attestation
A. Identification
I, [Your Name], Notary Public, verify that the affiant, [Name of Affiant], appeared before me and presented the following identification: [Type of Identification] bearing the number [Identification Number], issued by [Issuing Authority], and having an expiration date of [Expiration Date].
B. Oath of Affirmation
I administered an oath to the affiant, and the affiant acknowledged the truthfulness of the statements made in this affidavit.
C. Signature
The individual who made the sworn statement, also known as the affiant, has physically signed this legally binding document known as an affidavit, in my presence and under my watchful eye.
D. Seal
In an official capacity, I apply the impression of my authoritative seal to this present legal declaration known as an affidavit.
E. Certificate of Notary
I certify under PENALTY OF PERJURY under the laws of [Your State] that the foregoing paragraph is true and correct.
IV. Conclusion
IN WITNESS WHEREOF, I have hereunto set my hand and official seal.
[Your Name]
[Your Company Name]
[Your Company Address]
[Your Company Number]
[Your Company Email]
Sworn to (or affirmed) and subscribed before me on this [Day] day of [Month], [Year] by [Name of Affiant].
[Notary Public's Printed Name]
(Seal)
