Affidavit of Loss of Bill of Lading with Agreement to Hold Harmless

An Affidavit of Loss is a written statement declaring the physical loss of a document or a security - usually through theft or destruction. The affidavit contains all details regarding the loss, the owner's name and any information pertaining to the security, such as serial number or date of issue. Once the statement has been made, one can issue a letter of indemnity, requesting the replacement of the security or the delivery of the goods.

This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.