AFFIDAVIT FOR LOST OR NOT RECEIVED WARRANT State Form 42850 (R/06-01) Approved by State Board of Accounts 2001 Approved by the Auditor of State 2001 Warrant Payable To (Name): Street Address: City,.
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How to fill out the affidavit for lost or not received warrant State Form 42850 online
Completing the affidavit for lost or not received warrant State Form 42850 online is a straightforward process. This guide will provide you with step-by-step instructions to help you successfully navigate the form and submit your request with confidence.
Follow the steps to fill out the form accurately and efficiently.
- Click the ‘Get Form’ button to access the form and open it in your preferred editor.
- Begin by entering the name of the individual or entity to whom the warrant is payable in the 'Warrant Payable To' field.
- Provide your complete street address, including any necessary apartment or unit numbers, in the 'Street Address' field.
- Fill in the 'City, State, Zip' section with your city, state, and zip code, ensuring accuracy for proper identification.
- Enter your telephone number, including the area code, in the designated 'Telephone Number with Area Code' field.
- Input the warrant number exactly as it appears on any prior documentation pertaining to the warrant in the 'Warrant Number' field.
- Specify the amount of the warrant in the 'Warrant Amount' field, making sure to use the correct currency format.
- Indicate the date of the original warrant issuance in the 'Warrant Date' field.
- Select the reason for your request by checking the appropriate box, either 'I have not received this warrant' or 'I have received this warrant but it was lost, stolen or destroyed.' Provide any additional details if necessary.
- Certify the accuracy of the information by signing your name in the 'Signature of Requestor' field and entering the date in 'Date subscribed and sworn to Notary Public.'
- Print your name in the 'Printed Name of Requestor' section and include your social security or tax ID number.
- Complete the notary section by having your signature acknowledged by a Notary Public, who will fill in the date and their name as well.
- Once you have filled out the form, you can save your changes, download the document, print it, or share it as needed for submission.
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