affidavit as to lost stock certificate state of: … · affidavit . as to lost stock certificate ....
TRANSCRIPT
AFFIDAVIT
AS TO LOST STOCK CERTIFICATE
STATE OF:
COUNTY OF:
I, ______________, BEING DULY SWORN DEPOSES AND SAYS THAT I/WE ARE THE
DEPONENT AND RESIDE AT: ______________________________________________________________________________
(STREET NUMBER) (CITY) (STATE & ZIP)
THAT DEPONENT IS OR ARE THE BENEFICIAL HOLDERS OF ___________
SHARES OF THE CAPITAL STOCK OF ______________
DESCRIBED AS FOLLOWS: