of , , , , being duly sworn, does hereby swear and affirm as follows:

1. I am of legal age, and am an authorized officer, representative, or agent of , which is the sole legal and beneficial owner (the "Shareholder") of shares of stock, par value, of , a(n) corporation (the "Company"), represented by certificate number(s) (the "Original Certificate(s)"), issued on by the Company in the name of the Shareholder.

2. The Original Certificate(s) have been loststolendestroyed.

3. The Shareholder has made the following efforts to locate the Original Certificate(s)The destruction of the Original Certificate(s) occurred as follows:  .  .

4. The Original Certificate(s) were not endorsedendorsed as follows: .

5. None of the Original Certificate(s), or the Shareholder's rights in them, have, in whole or in part, been assigned, transferred, hypothecated, pledged, gifted, or otherwise disposed of in any manner whatsoever.

6. The Shareholder is entitled to the full and exclusive possession of the Original Certificate(s), and no other person or entity has any interest in the Original Certificate(s) or the proceeds from those.

7. If the Shareholder ever locates the Original Certificate(s), or if they are otherwise returned to the Shareholder, the Shareholder agrees that such Original Certificate(s) have no value and that it will surrender those recovered Original Certificate(s) to the Company immediately and without consideration for cancellation.

8. The Shareholder hereby requests and is making this affidavit for the purpose of requesting the Company to issue new or duplicate stock certificates in substitution for the Original Certificate(s).


The Shareholder is signing this affidavit on the date set forth below.

Date: ____________________


Signature of



Subscribed and sworn to before me this ____ day of _______, 20___, at _______, ____________.


Signature of Notary Public

Name of Notary Public: ______________________________________________                                                                               (SEAL)

Notary Public, State of

My commission expires: ____________________


Affidavit of Lost Stock Certificate - Free Template

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Affidavit of lost stock certificate: How-to guide

The world is largely dependent on electronic devices. Most workplaces are going paperless, and transactions are no longer limited to physical document exchange. 

However, physical documents or hard copies still play a significant role in some areas despite the prevalence of modern practices and systems. One such area is the representation and trading of shares.

Stockholders should be careful when storing critical physical certificates, which can be easily misplaced or destroyed. If this happens, an affidavit must be the first step in replacing the documents.

This guide helps to create an affidavit of a lost stock certificate. A company would require the affidavit if you lose your original certificate. This article covers the guidelines to create an affidavit of lost stock certificate to resolve the situation quickly and prevent potential investment loss.

What are the key aspects to consider for a lost stock certificate?

Placing a stop-transfer 

It is crucial to take immediate action to ensure that your missing stock certificate stays in the hands of the beneficial owner. Contact your agent and request a "stop transfer" on your original certificate. Thus, you can prevent unauthorized individuals from transferring the documents to their names. Moreover, your agent will report the original certificate as lost to the U.S. Securities and Exchange Commission's lost and stolen securities program, providing additional protection for your investments.

Requesting a new certificate

Requesting a new certificate or an affidavit for a lost stock certificate as soon as possible is important. If someone buys the lost certificate unknowingly, it may be impossible to cancel it and get a replacement, resulting in a permanent loss of your investment.

Purchasing an indemnity bond

Purchasing an indemnity bond may be required to safeguard your investment if you lose your original share certificate. This bond, which usually costs 2-3% of the current market value of your lost shares, can protect you from fraudulent sales.

Owning book-entry securities

Recently, the popularity of "book-entry securities" has increased. These securities are owned by a particular person or company but do not have corresponding physical stock certificates. This simplifies paperwork for both broker and owner, and neither party has to endure the cost and worry of replacing lost documents. Talk to your broker or the company if you are interested in converting your stock certificates to book-entry shares.

Replacing certificates in physical form

If you decide to obtain replacement certificates in physical form, make copies of those documents. This may help if those replacement certificates are lost or destroyed.

Tip: Protecting a stock certificate is essential since it holds great value and requires careful handling. There are options to minimize the cost and risks of keeping them safe. One of the ways is allowing your brokerage firm to keep these documents in their safe custody. It's a smart way to ensure their security.

Understanding the components of an affidavit of a lost stock certificate

The below points help you understand the components of an affidavit of a lost stock certificate.

Detailed description: A thorough description of the missing certificate, quoting the certificate number, is crucial to locate and retrieve it. Include the number of shares, par value, type of stock (e.g., common or preferred), date of issuance, and the name and type of the company that issued the stocks.

Endorsement: Indicate whether the stock certificates had been endorsed before you lost them. If they were endorsed, explain how this endorsement occurred (e.g., stock power, if you signed on the back of the certificate, and more).

Steps: Explain the steps taken to find the lost or stolen certificates. Demonstrate that you have made all reasonable efforts to retrieve these documents.

Notarize: You must notarize your signature on the affidavit. This requires that you go, in person, to a notary public. Be sure to bring with you a form of picture identification.

Frequently asked questions

What's an affidavit of the lost stock certificate?

Sometimes, stock certificates get lost or are accidentally damaged. Whether you keep, sell, or transfer them, you can recover the physical certificates. Contact the company or your agent to replace lost or damaged certificates. They will require you to provide an "affidavit of lost stock certificate" to prove that you are the sole legal entity owning it before issuing a new one.

What information is needed to complete an affidavit of lost stock certificate?

Here's the information you'll need to complete your affidavit of lost stock certificate:

  • Who it's coming from: Know for whom this document is being signed and where.
  • Circumstances: Be able to describe how the stock certificates were lost or destroyed.
  • Stock information: Have details like the company's name, the par value, and the type of stock certificates handy.
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