PDF Template
Lost/Stolen Bank Card Affidavit
Download a blank template to fill in by hand
This template includes fields for:
- Full Name
- ID Number
- Bank Name
- Card Type (Debit/Credit)
- Last 4 Digits of Card
- Date Lost/Stolen
- Circumstances (Lost/Stolen)
- Last Known Location
- Has Card Been Blocked? (Yes/No)
- Police Case Number (if applicable)
- Contact Number
or
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1
Download and print
Download the PDF template and print it out on A4 paper.
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2
Fill in your details
Complete all the fields with a blue or black pen. Write clearly and legibly.
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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).
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4
Bring your ID
Remember to bring your South African ID document or passport when going to commission your affidavit.