Printable Business Form Templates
Affidavit Of Lost Note Business Form Template


STATE OF ____________________
COUNTY OF ____________________

I, ____________________, residing at ____________________, in the county of ____________________ in the state of ____________________, having been duly sworn, do hereby depose and attest:

  1. I am the sole owner of the lost promissory note or other indebtedness, executed by ____________________ , on behalf of the Trustee, ____________________ , in the amount of ____________________ and date as of ____________________, OR that I am the authorized officer, agent, or representative of the company that is the sole owner of the note.
  2. The note has been lost, misplaced, damaged or destroyed and cannot be produced, located or recovered after the exercise of due diligence.
  3. The amount still owed to the holder is ____________________ , OR The amount has been paid in full as of ____________________. The note has not been transferred or sold to a third party.
  4. This affidavit is made knowing that the Borrower, ____________________, will rely on the truth and validity of the statements made in this document.


Subscribed and sworn to before me this ____________________ day of ____________________ 20 ____________________

(Notary Public),

____________________ County.

My commission expires ____________________ 20 ____________________

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