What this draft covers
- Details of the lost share certificate and flat
- Circumstances of loss and police complaint
- Declaration that the certificate is not pledged or transferred
- Indemnity to the Society
- Undertaking to return the original if found
When to use it
Use when a share certificate of a co-operative housing society is lost or destroyed and the member applies for a duplicate.
Format: Editable Word document (.docx), 2 pages.
Preview
[On stamp paper of the applicable value]
AFFIDAVIT CUM INDEMNITY
I, [full name], aged about [●] years, [occupation], residing at [address], [PAN / Aadhaar: last four digits ●], do hereby solemnly affirm and state as under:
1. I am a member of [Name of the Society] Co-operative Housing Society Ltd. (the “Society”) and hold Flat No. [●]. The Society had issued to me Share Certificate No. [●] for [five] shares of ₹50 each bearing distinctive Nos. [●] to [●] (the “Certificate”).
2. The original Certificate has been [lost / misplaced / destroyed] on or about [date] [describe circumstances]. Despite a diligent search, it has not been found.
3. I lodged a complaint about the loss with [name] Police Station on [date], recorded under [lost property report / NC] No. [●]. A copy is annexed. I have also published a notice in [newspapers] on [date]; no claim has been received.
4. …
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