Affidavit of Lost Promissory Note — New York

AFFIDAVIT OF LOST PROMISSORY NOTE — NEW YORK

Before you use this: Complete only facts the affiant knows or can identify from records. Attach an available copy of the note and transfer records. Ask the recipient whether it requires its own affidavit, a bond, or other protection. Do not sign until the oath or affirmation is administered.

State of New York

County of [COUNTY]

I, [AFFIANT FULL NAME], being duly sworn or affirmed, state:

1. I am [ROLE AND RELATIONSHIP TO THE NOTE]. My address is [ADDRESS]. I know the facts below because [DESCRIBE PERSONAL KNOWLEDGE AND RECORDS REVIEWED].
2. The missing promissory note is identified as follows: maker [NAME]; original payee [NAME]; date [DATE]; original principal [AMOUNT]; maturity date [DATE OR TERMS]; account or loan identifier [IDENTIFIER]; collateral, if any, [DESCRIPTION]. Its unpaid amount as of [DATE] is [AMOUNT], based on [IDENTIFY PAYMENT RECORDS].
3. The note's material terms, including payment and interest terms, are [SET OUT TERMS OR IDENTIFY ATTACHED TRUE COPY]. ☐ A true copy is attached as Exhibit A. ☐ No copy is available; the terms are established by the records identified in Exhibit [LETTER].
4. The note came into the possession of [PERSON OR ENTITY] on [DATE] by [DESCRIBE DELIVERY OR TRANSFER]. The chain of possession and any endorsements or assignments known to me is [DESCRIBE; IDENTIFY AND ATTACH RECORDS].
5. The original was last known to be in the custody of [PERSON OR DEPARTMENT] at [PLACE] on [DATE]. I learned it was missing on [DATE]. The circumstances of its loss, destruction, theft, or unknown location are [FACTS; SAY WHAT IS UNKNOWN].
6. The following search was made for the original: [LOCATIONS, RECORD SYSTEMS, PERSONS CONTACTED, DATES, AND RESULTS]. The original ☐ was destroyed ☐ cannot be located ☐ is believed to be in another person's possession because [EXPLAIN].
7. To my knowledge, the note has ☐ not been paid in full ☐ not been cancelled ☐ not been intentionally transferred away after the loss. Explain any exception or uncertainty: [DETAILS].
8. I own the note because [DESCRIBE ACQUISITION AND ATTACH DOCUMENTS]. The facts preventing production of the original are [DESCRIBE SPECIFICALLY]. Its terms are shown by [IDENTIFY COPY OR OTHER RECORDS].
9. I submit this affidavit to [RECIPIENT] for [SPECIFIC PURPOSE]. If I bring an action under N.Y. U.C.C. Law § 3-804, I understand that I must prove ownership, the facts preventing production, and the terms. The court must require security in an amount it fixes, at least twice the allegedly unpaid amount, to indemnify the defendant and successors against further claims, except for the statute's state/public-officer exception. I will address that security separately; this affidavit is not the security.
10. I will promptly notify [RECIPIENT] if the original is found or a competing claim appears.

I have read this affidavit. The statements above are true to my personal knowledge except where I expressly identify records or another source.

Affiant signature: ______________________________ Date: [DATE]

Printed name and title: [NAME AND TITLE]

Exhibits: [LIST EACH ATTACHMENT OR WRITE NONE]

Oath or affirmation

Sworn to or affirmed and subscribed before me by [AFFIANT NAME] on [DATE] at [PLACE].

Notarial officer signature: ______________________________

Printed name and title: [NAME AND TITLE]

Commission, seal, and other details required where the oath is administered: [COMPLETE OR ATTACH LOCAL JURAT]