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Affidavit Of Forged Signature
STATE OF ----------)
COUNTY OF ---------)
The undersigned, being duly sworn, deposes and says:
I am over the age of eighteen years and, on [date], was and still am a depositor in [bank] at its [address] office.
That on [date], only I was authorized to draw checks on or indorse checks to [bank] on my account number [number].
I have examined the signature "[name]" of check number [number] dated [date] purported to be drawn by me on [bank] and hereby state: that I did not write or authorize to be written this signature.
The signature is a forgery and was made by someone unknown to Affiant.
The purpose of this Affidavit is to induce [bank] to credit my account number [number] in the amount of this check.
*** If Required By FederaL or State Law ***
This Section for Notary:
State of _________
County of ________ [COUNTY]
On [DATE] before me, [NAME OF NOTARY], notary, personally appeared [NAME OF PERSON(S) INVOLVED], personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument.
Witness my hand and official seal.
My commission expires: _____