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Unauthorized Signature Or Endorsement {AFF-212}
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Description
AFFIDAVIT - UNAUTHORIZED SIGNATURE OR ENDORSEMENT State of: County of: I, (depositor), being first duly sworn, affirm that I reside at (address), (city), County, (state). On (date), I was shown check number , dated , for the amount of $. The check was payable to (payee), and was drawn on (account number and name of bank). I have examined the (signature or endorsement) on the check described above. Though the (signature or endorsement) purports to be mine, it is a forgery. I did not execute the instrument, nor did I authorize another person to execute it on my behalf. I have received no benefits from the proceeds of the check. I make this affidavit to induce (bank) to reimburse me in the check amount of $. State of: County of: This instrument was acknowledged before me on (date), by, (name(s) of person(s)). (Signature of notarial officer) (Seal) (Title or Rank of Officer) (My commission expires: ) American LegalNet, Inc. 251 www.FormsWorkFlow.com
