Indemnity Regarding Lost Share Certificate

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This Indemnity Regarding Lost Share Certificate indemnifies a corporation from actions or claims when a shareholder reports a share certificate as lost, misplaced or destroyed.

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This Indemnity Regarding Lost Share Certificate will indemnify a corporation from any action or claim in the event a shareholder has lost or misplaced a share certificate. This indemnity contains the name of corporation issuing the certificate, name of individual to whom the certificate was issued and number of shares. It also sets forth that if the certificate is located, the shareholder will surrender it to the corporation for cancellation. A written Indemnity Regarding Lost Share Certificate will prove invaluable in the event of misunderstandings or disagreements.

This Indemnity Regarding Lost Share Certificate includes the following:
  • Parties: Names of corporation issuing the shares and the shareholder to whom the shares were issued;
  • Declaration: Shareholder declares that the shares have not been transferred or sold and that the certificate was lost, misplaced or destroyed;
  • Indemnity: Shareholder warrants that all statements are true and indemnifies the corporation from any claims or actions arising from the loss of the certificate;
  • Signatures: The shareholder must sign and date this document in the presence of a witness.

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This attorney-prepared packet contains:
  1. General Information
  2. Indemnity Regarding Lost Share Certificate
State Law Compliance: This form complies with the laws of all states
Number of Pages3
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#28518
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.
Indemnity Regarding Lost Share Certificate



TO:   Name of Corporation Issuing Stock Certificate
WHEREAS Name of Person to Whom Lost Stock Certificate was Issued (the “Holder”) is the holder of Number of Shares Held by Holder of Lost Stock Certificate Type of Shares Held by Holder of Lost Stock Certificate (ie. Common, Preference, etc.) shares (the "Shares") in the capital of Name of Corporation Issuing Stock Certificate (the “Corporation”);
AND WHEREAS the Holder has not sold, transferred, assigned, pledged, hypothecated or otherwise encumbered the Shares in any manner;
AND WHEREAS a certificate representing the Shares has either never been prepared, or has been mislaid, stolen or destroyed so that the same cannot be found or produced;
NOW THEREFORE in consideration of the Corporation agreeing to issue or causing to be issued a new stock certificate representing the Shares, the Holder covenants and agrees with the Corporation as follows:
1.   The Holder represents and warrants that the recitals to this Indemnity are true and correct.
2.   The Holder agrees to indemnify and save harmless the Corporation from and against all claims, actions, suits, liabilities, losses, damages, costs, charges and expenses (including legal fees) of every nature and character arising out of or in consequence of the issuance of a new certificate representing the Shares in the name of the Holder.
3.   If at any time a previous certificate representing the Shares should be found or come into the possession of or under the control of the Holder, the Holder will forthwith obtain and surrender such previous certificate to the Corporation for cancellation.
This Indemnity shall be binding upon the Holder and its successors and assigns and shall enure to the benefit of the  Corporation and its successors and assigns.
DATED: Date of Signing of Indemnity
Full Name of Person to whom Cheque was made out to

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