Affidavit of Forgery Template

This Affidavit of Forgery (the “Affidavit”) is made on [Date] by:

Affiant: [Full Name], address: [Address], phone/email: [Contact].
Relationship/Role (Optional): ☐ Account holder ☐ Document signer ☐ Authorized representative ☐ Other: [Explain]

1. Purpose

1.1 I am making this Affidavit to report a suspected forgery and dispute an unauthorized signature/document described below.

2. Disputed Document / Transaction

2.1 Document/Transaction Type: ☐ Check ☐ Contract ☐ Authorization form ☐ Letter ☐ Other: [Type]
2.2 Date on Document/Transaction: [Date]
2.3 Counterparty / Institution: [Bank/Company/Agency name]
2.4 Account/Reference Number (Optional): []
2.5 Amount (If Applicable): $[]
2.6 Description: [Brief description of the document or transaction].

3. Statement of Non-Authorization

3.1 I did not sign the document/authorize the transaction described above.
3.2 I did not give any person permission to sign on my behalf.
3.3 The signature appearing on the document is not my signature (or was not signed by me).

4. How I Discovered the Forgery (Optional)

4.1 I discovered the issue on [Date] when: [Explain briefly].
4.2 Any known suspected person(s) (optional): [Name(s)], if known.

5. Actions Taken (Optional)

5.1 I notified: ☐ the institution/company ☐ law enforcement ☐ credit bureaus ☐ other: [List].
5.2 Police Report (If Any): ☐ Not filed ☐ Filed (agency: [], report no.: [], date: [__]).

6. Signature Sample (Optional)

6.1 My true signature sample (optional): ___________________________
6.2 Additional identity verification provided: ☐ Yes ☐ No.

7. Attachments (Optional)

7.1 ☐ Copy of disputed document/transaction record
7.2 ☐ Account statement showing transaction
7.3 ☐ Photo ID (copy)
7.4 ☐ Police report (if filed)
7.5 ☐ Other: [List]

8. Statement Under Oath

8.1 I declare under penalty of perjury that the statements in this Affidavit are true and correct to the best of my knowledge.

Signatures

Affiant: [Full Name]
Date: [Date]
Signature: ___________________________

Witnesses (If Required)

Witness Name: [Name]
Date: [Date]
Signature: ___________________________

Notary / Notarization (If Required)

State of [State]
County of [County]

On [Date], before me, [Notary Name], personally appeared [Affiant Full Name], known to me (or satisfactorily proven) to be the person whose name is subscribed to this Affidavit, and acknowledged that they executed it for the purposes stated.

Notary Public Signature: _______________________
My Commission Expires: _______________________
Notary Seal (if applicable): ___________________