PDF Template

Loss (General) Affidavit

Download a blank template to fill in by hand

This template includes fields for:

  • Full Names and Surname
  • South African ID Number
  • Description of the Lost Item or Document
  • Issuing Party
  • Reference / Serial / Certificate Number
  • Approximate Date of Loss
  • How the Item Was Lost
  • Last Known Location
  • Efforts Made to Locate the Item
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How to Use This Template

  1. 1
    Download and print

    Download the PDF template and print it out on A4 paper.

  2. 2
    Fill in your details

    Complete all the fields with a blue or black pen. Write clearly and legibly.

  3. 3
    Commission at a police station

    Take the completed form to any South African Police Station. A Commissioner of Oaths will verify your identity and witness your signature (free of charge).

  4. 4
    Bring your ID

    Remember to bring your South African ID document or passport when going to commission your affidavit.