Affidavit of Forgery Template

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Updated January 10, 2022

An affidavit of forgery is an official declaration that a fraudulent act was committed. It should be completed, notarized, and sent to notify institutions. In addition, a police report should be filed in the jurisdiction where the forgery took place.

Getting Notarized

Most financial institutions will demand a notarized affidavit of forgery and a police report before starting a claim to return lost funds. Attach a notary acknowledgment (if needed).

Common Types of Forgery (8)

  • Asset and property records
  • Credit cards
  • Insurance
  • Investment accounts
  • Estate documents
  • Personal & business checks
  • Retirement savings
  • Tax refunds

How to Write

Download: Adobe PDF, MS Word, OpenDocument

I. Claimant Declaration

(1) Formal Statement Date. Before completing this form, the date that the Claimant executes this document with a notarized signature will require presentation as this paperwork’s introduction.

(2) Claimant Name. Establish the Claimant’s identity with a production of his or her legal name.

(3) Claimant Address. The Claimant’s mailing address is required in the first article with his or her name. This address must be a reliable and well-monitored address where the Claimant can be contacted by mail.

(4) Direct Contact Information. The Claimant’s telephone number and email address must also be submitted to this document.

II. Document In Question

(5) Type Of Forgery. The document that was forged will need to be clearly identified in this statement. To this end, Article II, shall require that it is properly categorized. Review the list on display in this section then indicate if the forged document is a “Check,” “Credit Card,” or “Loan” by placing a mark in the corresponding checkbox. If the forged document cannot be categorized as any of these items, then select the “Other” checkbox and define the type of document forged to the space provided.

III. Forgery Statement

(6) Formal Claimant Declaration. Now that the document that was forged has been properly classified, the Claimant’s statement should be presented. This should be a clear and full report on what was forged, how it was forged, and why it is believed that the document being discussed has been falsely made or issued. Any paperwork that can support this statement should be attached and cited in this section.

IV. Status Of Police Report

(7) Date Of Filed Police Report. If the Claimant has filed a police report reporting this forgery, then place a mark in the first checkbox in Article IV. Additionally, the date when the police report was officially recorded should be dispensed.

(8) Pending Police Report Filing. If the Claimant did not file a police report but plans on doing so within a reasonable amount of time from the execution of this paperwork, then select the second checkbox statement in Article IV.

(9) Conditional Filing. If the Claimant did not file a police report but can and will do so provided it is required for this affidavit to be complete, then select the third checkbox from this list.

(10) Other. There may be another status that must be presented to define the status of a police report on this forgery. For instance, the Claimant may be dependent upon another party to file a police report or may be prevented from doing so as a result of complicated circumstances. If so, then select the final statement and define the status of the police report using the space available after the word “Other.”

V. Final Statements And Execution

(11) Claimant Signature And Name. The Claimant issuing this statement must sign his or her name as well as print it. Some jurisdictions may require this to be done under the observance of a specific Party (i.e. a Notary Public, a Court Officer, etc.). Make sure that that this signing occurs under the requirements placed by the State where it is executed.

(12) Claimant Signature Date. The signature of the Claimant must be accompanied with a presentation of the calendar date at the time of signing.