Affidavit of Lost Documents

(Minute Book)

Document 1515A www.leaplaw.com

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 AFFIDAVIT OF LOST DOCUMENTS

I, the undersigned, do hereby state and declare as follows:

On [DATE OF INCORPORATION], [COMPANY NAME], a ___________________

corporation (the Corporation) was organized by [NAME OF INCORPORATOR(S)]. The
current Director(s) of the Corporation is/are [NAME OF DIRECTOR(S), and the current
STOCKHOLDER[S] of the Corporation is/are [NAME OF STOCKHOLDERS].

The Minute Book and Stock Book of the Corporation (the Corporate Records) have
been lost. A duplicate Stock Book and Minute Book have been created (together, the
Replacement Records). The Replacement Records contain copies of all available documents
relating to the Corporation, and as of this date, shall be used to maintain any future Corporate
documents.

Dated as of the __________ day of _____________, 20__.

[COMPANY NAME]

By: ___________________________
Its: Secretary

ACKNOWLEDEGEMENT

[STATE] ) s.s.:
[COUNTY] )

On this [_______] day of [__________], 20[__], before me, the undersigned notary
public appeared __________________, the Secretary of [COMPANY NAME], and proved to
me through satisfactory evidence of identification, which were ___________, to be the person
whose name is signed above, and who swore or affirmed to me that the contents of the document
are truthful and accurate to the best of (HIS/HER) knowledge and belief.

________________________________
[Typed Name], Notary Public
My Commission Expires: ________

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