Below is the  Affidavit Of Losstemplate body. If necessary, please put the personal information, company information, such as text to replace the specific content you need. you can download the .doc template file on the end of the article by click download link. 

AFFIDAVIT OF LOSS



I, [SPECIFY NAME], domiciled and residing at [YOUR COMPLETE ADDRESS], do hereby solemnly declare that:


I am the [TITLE] of [COMPANY] and as such have knowledge of the facts herein declared.

[COMPANY], a wholly-owned subsidiary of [SPECIFY COMPANY], executed a Trust Deed of Hypothec bearing formal date of [DATE] in favor of [SPECIFY]. (SPECIFY), which deed was registered at the Registry Office in and for the Registration Division of [SPECIFY PLACE] on [DATE] under the number [NUMBER] (the Trust Deed).

[SPECIFY COMPANY] issued a [%] mortgage bond certificate number [NUMBER] in the principal amount of [AMOUNT] in legal currency of [COUNTRY] (the Bond) pursuant to the Trust Deed, which Debenture [SPECIFY COMPANY] then pledged in favor of [SPECIFY COMPANY] on [DATE], and which pledge was registered by [SPECIFY] in the register kept for such purpose, as per the trustees attestation on the reverse of the Bond (a photocopy of which is attached hereto).

[SPECIFY COMPANY] assigned the indebtedness of [SPECIFY COMPANY] which the Trust Deed was executed and the Bond issued and pledged to secure (the Indebtedness) to [SPECIFY COMPANY] (COMPANY) pursuant to an Agreement of Absolute Assignment dated as of [DATE] by and between [SPECIFY COMPANY] and [SPECIFY COMPANY] (the Assignment) (a copy of which is attached hereto).

[SPECIFY COMPANY] has received the Bond, but has lost same, and although [SPECIFY COMPANY] has made a due and diligent search therefore, [SPECIFY COMPANY] has been unable to find the Bond.

Said Bond has not been endorsed by [SPECIFY COMPANY], save and except for the endorsement to [SPECIFY] as of [DATE] (the Endorsement) pursuant to the Assignment (a copy of the Endorsement is attached hereto). Save and except for the Assignment and Endorsement, [SPECIFY COMPANY] has not executed or signed any other instrument of transfer in connection with the Bond or the Indebtedness, nor has [SPECIFY COMPANY] otherwise sold, assigned, transferred, pledged, hypothecated or in any way encumbered or disposed of the Bond or the Indebtedness or any rights therein.

[SPECIFY COMPANY] hereby accordingly requests [SPECIFY] to issue a new mortgage bond certificate to [SPECIFY COMPANY] in replacement of the Bond lost and assigned to [SPECIFY COMPANY].

I have executed this Affidavit of Loss in support of [SPECIFY COMPANY]s request that a new mortgage bond certificate be issued to [SPECIFY COMPANY] by [SPECIFY].



DATED this [DAY] day of [MONTH, YEAR].



AND I HAVE SIGNED



SOLEMNLY DECLARED before me
at [SPECIFY PLACE] this [DAY] day
of [MONTH, YEAR]





            
Commissioner for Oaths, Notary Public,
Solicitor authorized to administer oaths
or equivalent


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