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Click ‘Get Form’ to open the AFFIDAVIT OF UNAUTHORIZED PAPER DEBIT in the editor.
Begin by filling in the 'State of' and 'County of' fields at the top of the form. This information is essential for jurisdiction.
In the first section, provide your name and select whether you are an individual or an authorized signer. If you are a signer, include the name of the entity and your title.
Indicate your relationship to the account by checking all applicable boxes: Owner, Maker, or Payee of the item described.
Fill in details about the unauthorized check, including account number, date, check number, and amount. Ensure accuracy as this information is crucial for your claim.
Select one reason for claiming unauthorized status from options like Counterfeit or Forged Maker. Provide any necessary details regarding alterations if applicable.
Sign and date the affidavit at the bottom. Ensure that your signature matches what is on file with your bank.
If required, have a notary public witness your signature and complete their section before submitting.
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a sample letter to report an unauthorized transfer
Specifically (select one):. I never authorized the debit to this company. I authorized debits to this company but revoked the authorization on Read more
I am attaching a copy of the original check or ledger showing proof of the original item. Complete for the altered areas of the check: Original. Changed to.Read more
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