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Affidavit of Loss - Online Template Form - Word and PDF

Affidavit of Loss

State: Alabama
County: ________

I, the undersigned, do swear and confirm the following facts:

1. My legal name is as follows: ________.

2. My date of birth is ________.

3. My present address and telephone number are as follows:

________
________

4. I am the lawful owner of the following document: Alabama Driver's License, number ________, issued on ________.

5. On or about ________, I lost or discovered the loss of the document described above.

6. The following are the details of how I lost the document:

________

7. I am requesting a replacement of the lost document.

8. I have made all efforts to retrieve the lost document, to no avail.

9. I provided the following form of identification to the Notary Public to prove my identification:

________

11. The below is my true and correct signature.

I swear under penalty of perjury that I am the party described above and that all statements in this Affidavit of Loss are true.


________


Signature: _____________________


Date: _________________________

State of Alabama NOTARIZATION:

State: Alabama
County: ________

WITNESS my hand and official seal:


Seal:


Name: __________________________________



Signature: _______________________________



My commission expires: ____________________

Fields you complete are inserted into the document live. This template is general guidance only - not legal advice.