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Affidavit of Lost Cheque or Bank Draft
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AFFIDAVIT OF LOST CHEQUE OR BANK DRAFT
I, ______, of ______, in the Province of Ontario, MAKE OATH AND SAY (or AFFIRM) that:
A ______ in the amount of ______, payable to ______, was issued by ______.
Instrument / serial number (if known):
Date of issue, on or about (if known):It was lost in the following circumstances: ______.
The instrument has not been cashed, endorsed, or transferred by me, and I have been unable to locate it.
I request that the issuer stop payment and reissue it, and I will return the original if it is found.
I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
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