Fill and Sign the Affidavit Claimant Form

Affidavit by Claimant of Lost Property STATE OF ____________________ COUNTY OF _______________________ PERSONALLY appeared before me, the undersigned authority in and for said county and state, __________________ (Name of Affiant) , who, having been being first duty sworn by the undersigned Notary Public, deposes and says: 1. Affiant resides at __________________________________________________ ____________________________________ (street address, city, state, zip code) . 2. Affiant is the owner of the following described personal property: (description of personal property) _____________________________________________________ _____________________________________________________________________. 3. Affiant acquired this property by (e.g. purchase or gift) _________________, on _________________ (date) . Evidence of Affiant's ownership is a document entitled _____________________ (title of document) , a copy of which is attached as Exhibit A and incorporated by reference. 4. Affiant first became aware that the above-described property was lost or missing on or about ____________________ (date) . 5. On ____________________ (date) , Affiant reported the fact that the property was missing or lost to the _______________ (name of city) , ______________ (name of state) Police Department. 6. On __________________ (date) , Affiant was informed by __________________ (name of informant) , that certain property similar to the description of the property described above was found. 7. On ________________ (date) , Affiant went to ___________________________ ______________________________________________________ (street address, city, state, zip code) , to examine the property that was found, and after examining the property, Affiant determined that it was Affiant's missing or lost property. 8. Affiant has not sold, assigned, pledged or in any other manner encumbered the above-described property. 9. Affiant is executing this affidavit to support Affiant's claim of ownership to the above-described property. ________________________________ (Printed Name of Affiant) ________________________________ (Signature of Affiant) SWORN to and subscribed before me, this the ____ day of ______________, 20____. _________________________ NOTARY PUBLIC My Commission Expires: ___________________