An Affidavit of Loss Form is a crucial legal document used in New Zealand when individuals or organizations need to formally declare the loss of important items or documents. This sworn statement, governed by New Zealand's Oaths and Declarations Act 1957, provides a legal framework for reporting losses and requesting replacements. The document is commonly used for lost certificates, identification documents, property titles, share certificates, or other valuable items. The Affidavit must include detailed information about the lost item, circumstances of the loss, and efforts made to locate it. It requires execution before an authorized person such as a Justice of the Peace or solicitor, making it a formal legal declaration with serious consequences for false statements. The document serves as protection for both the declarant and any institution issuing replacements, and may be required by various organizations as part of their risk management and compliance procedures.

1. Title and Declaration Statement: Formal title 'Affidavit of Loss' and statutory declaration statement as per NZ law

2. Declarant Information: Full legal name, address, and occupation of the person making the affidavit

3. Description of Lost Item: Detailed description of the lost item including unique identifiers, serial numbers, or reference numbers

4. Circumstances of Loss: Detailed account of when, where, and how the item was lost or discovered to be missing

5. Search Efforts: Description of steps taken to locate the lost item

6. Current Status: Statement confirming item remains lost and hasn't been transferred or pledged to others

7. Purpose of Affidavit: Statement explaining why the affidavit is being made (e.g., replacement of documents)

8. Sworn Statement: Formal declaration of truth and acknowledgment of legal consequences for false statements

9. Execution Block: Space for signature, date, and witness/notary details