Fill and Sign the Affidavit in Lieu of Lost Passport Form

IN THE _____________ COURT OF _______________ (County), ______________ (State)_______________________ PLAINTIFF(Name of Plaintiff)V. CAUSE NO. ______,_____________________________ DEFENDANT(Name of Defendant) State of __________________________County of _____________________________________________ (Name of Affiant), being first duly sworn, deposes and says that:1. Affiant resides at ________________________________________ (address), __________________ (city), __________________ County, ________________ (state).2. Affiant is the claimant named in the attached claim for $____________ against _______________________ (name of defendant).3. Affiant held a passport issued by __________________ (nation) on ______________ (date), prior to Affiant's departure for the United States.4. Affiant lost this passport on or about _______________ (date), while a passenger on ______________________________ (name of train, airline, or bus line) traveling between _____________________ (name of location) and ______________________ (name of location).5. In lieu of the passport, Affiant submits the following information relative to Affiant's last and only entry into the United States: A. Date of entry: ________________________B. Port of entry: ____________________________________________________C. Name of ___________________ (airline or ship) on which Affiant arrived: ____________________________________________6. Affiant has resided continuously in the United States ever since Affiant's entry on _________________ (date).7. This Affidavit is made to induce _______________________ (name of defendant) bank to recognize Affiant's attached claim.8. ________________________________(Signature of Affiant)________________________________(Print or Type Name)SWORN to and subscribed before me, this the ______ day of ______________, 20____.__________________________NOTARY PUBLICMy Commission Expires: _________________