Get And Sign Affidavit For Lost, Stolen, Or Destroyed Stock Certificate Form

Zip code). 2. That I am the legal and beneficial owner of __________ (number) shares of the (specify class) _________________________ stock of ________________________ (name of corporation) represented by certificates described as follows: Number: _________ Date: ________________ (state number) (state date) Registered Name: ______________ _____________________________ (state registered name) 3. That said certificates _______________ (were or were not) endorsed. 4. That I have not...