Affidavit for Lost, Stolen, or Destroyed Stock Certificate

If you lose a stock certificate, whether through fire, theft or some other means, replacing that certificate is a relatively straightforward process. You will need to contact the company's stock transfer agent, and you may have to post a surety bond that will cost approximately 3 percent of the value of the certificates being replaced.

If you do not have an address for the company's stock transfer agent, contact the company and ask for the agent's address. Tell the company's stock transfer agent how many shares have been lost and the approximate date on which they were purchased.

This form is a generic example that may be referred to when preparing an affidavit for the transfer agent. It is for illustrative purposes only.