How to Fill Out and Submit the Computershare Lost Certificate Affidavit

The Computershare Lost Certificate Affidavit is the sworn form you file to replace a stock certificate that has been lost, destroyed, or stolen. To submit it, call Computershare to place a stop transfer on the missing certificate, complete the affidavit with a Medallion Signature Guarantee, pay the indemnity bond premium plus Computershare’s $80 processing fee, and mail the full package to Computershare’s processing center. Replacement shares are almost always issued electronically through the Direct Registration System rather than as a new paper certificate.

Call Computershare First and Request a Stop Transfer

Before you fill out anything, call Computershare’s shareholder services line. The number varies by the company whose stock you own; you’ll find it on a recent account statement or through the Computershare Investor Center at www.computershare.com/investor. Ask the representative to place a stop transfer on the missing certificate numbers. That flags the certificates in Computershare’s system so nobody can present them for transfer or sale while your replacement is in progress.

On the same call, ask them to mail you the replacement package. It contains the Lost Securities Affidavit and the instructions for the indemnity bond. If the shares belong to an estate or trust, or if the certificate value exceeds $250,000, say so during the call. Computershare uses a separate process with additional documentation for those situations.

Information You Need Before Filling Out the Affidavit

Have the following in front of you when you sit down with the form:

  • Your full legal name exactly as it appears on the account
  • Your Social Security number or Tax Identification Number
  • Your Computershare account number, which appears on statements and in the Investor Center portfolio view
  • The certificate numbers of the missing certificates and the number of shares each represents

Your Computershare account distinguishes between shares held in book-entry form and shares issued as physical certificates. The Investor Center portfolio view shows this breakdown. If you can’t log in and don’t have statements, the phone representative can read the certificate numbers and share counts off the file.

What You’re Signing

The Lost Securities Affidavit is a sworn statement, signed under penalty of perjury, declaring that the certificates are no longer in your possession and that you have not sold, pledged, or transferred them to anyone else. The form asks for the certificate numbers, the number of shares on each, and a description of how the loss happened.

The indemnity bond is what actually allows the replacement to go through. Under the Uniform Commercial Code, a company must issue a replacement certificate when the owner requests one, files a sufficient indemnity bond, and meets any other reasonable requirements the issuer imposes. The bond protects the issuing company, Computershare, and the surety if the original certificate later resurfaces and an innocent third party tries to cash it in. Computershare’s standard program uses a blanket bond issued by Liberty Mutual Insurance Company. Signing the affidavit means you agree to indemnify Liberty Mutual, Computershare, and the issuer against any resulting losses, costs, or legal fees.

You Need a Medallion Signature Guarantee, Not a Notary

This is the step that trips people up. Computershare requires a Medallion Signature Guarantee on the affidavit. A notary seal is not accepted.

A notary verifies your identity and witnesses your signature. A Medallion guarantee does that and also commits the financial institution stamping it to financial liability if the signature turns out to be fraudulent. That liability backing is why transfer agents insist on it for securities transactions.

You can get a Medallion guarantee from a commercial bank, savings bank, credit union, or brokerage firm that participates in one of the approved Medallion Signature Guarantee Programs. Most institutions will only guarantee signatures for their own customers, so your first stop is the bank or brokerage where you already have an account. Call ahead. Not every branch handles Medallion stamps, and larger-value guarantees sometimes require an appointment.

What It Costs

The indemnity bond premium is calculated on the current market value of the missing shares. The SEC’s investor education division puts the typical bond cost at roughly two to three percent of the market value of the lost certificates. Some surety companies quote annual premiums in the one to two percent range, so the exact rate depends on the surety and the issuer’s arrangement.

On top of the bond premium, Computershare’s standard affidavit form charges an $80 processing fee, and the bond premium has a $20 minimum for small positions. Even a certificate worth only a few hundred dollars costs at least $100 to replace between the minimum premium and the processing fee.

A concrete example: a lost certificate representing $15,000 in stock at a 2% bond rate runs $300 in bond premium plus the $80 processing fee, for $380 total. The fees are non-refundable. Make your check or money order payable to “Computershare”; Computershare forwards the bond premium portion to Liberty Mutual.

Where to Mail the Package

Once the affidavit is completed, Medallion-guaranteed, and paired with your check, send the whole package to Computershare’s processing center. The address depends on the carrier.

Standard mail:

Computershare
PO Box 43007
Providence, RI 02940-3007

Overnight or courier (FedEx, UPS):

Computershare
150 Royall Street, Suite 101
Canton, MA 02021

Some issuers direct shareholders to a different Computershare address. Check the instruction sheet that came with your affidavit forms and use whatever address it specifies. If it doesn’t specify one, use the standard addresses above. Ship with tracking. You’re mailing a sworn legal document, a check, and materials tied to a financial account, and Computershare will not begin its review until the completed paperwork and full payment arrive together.

What Happens After You Submit

Computershare verifies your information against the master shareholder file, confirms there are no conflicting claims on the shares, and coordinates with the surety to activate the bond. Straightforward claims can wrap up in a few weeks; cases involving estates, high-value positions, or issuer-specific complications take longer. There is no published universal turnaround. If you need the shares available by a specific date, call to check status rather than assume a deadline.

During processing, Computershare voids the old certificate numbers and reports them to the Lost and Stolen Securities Program, a federal database operated by the Securities Information Center under SEC Rule 17f-1. Transfer agents, brokers, banks, and clearing agencies are required to check certificates valued over $10,000 against this database before accepting them. If anyone presents your old certificate, the system flags it and blocks the transaction.

Your replacement shares will almost certainly be issued through the Direct Registration System rather than as a new paper certificate. DRS holds the shares electronically in your name on the company’s books, and you receive a Statement of Account or DRS Advice as confirmation. Electronic registration carries the same ownership rights as a paper certificate and can be managed through the Computershare Investor Center.

If the Certificate Was Stolen

A stolen certificate follows the same affidavit process as a lost one. Report the theft to your local police and keep a copy of the report. Federal law does not require individual investors to file a police report, but having one strengthens your position if the certificate later turns up in someone else’s hands. The stop transfer you request on your first call to Computershare is the step that actually blocks the certificate from being used.

If the Registered Owner Has Died

When the registered owner of a lost certificate has died, the executor named in the will or the administrator appointed by the probate court is the person who files the affidavit. Computershare generally requires a certified copy of the death certificate and Letters Testamentary or Letters of Administration. The affidavit form itself instructs you to contact Computershare directly for estate or trust situations, because requirements vary by issuer and by the size of the position. Some states allow transfers of smaller holdings using a small estate affidavit rather than full probate, but thresholds vary widely and not every transfer agent accepts them. Call Computershare before assembling paperwork so you know exactly what they need for your situation.