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Cardholder's Report of Stolen Credit Card
Since receiving the ___________(3)_____________ issued under
the number __________(4)___________, it has been stolen. The
card was stolen on or about _____(5)______, 19__(6)_. The
card was stolen under the following circumstances: (Describe
Situation) I notified ____________(7)_______________ by telephone
of the theft of the card on ________(8)____________, 19__(9)_.
You are hereby authorized to take all steps necessary and
to notify the appropriate authorities to avoid illegal use
of the above-numbered credit card. ___________(10)_______________
NOTICE The information in this document is designed to provide
an outline that you can follow when formulating business or
personal plans. Due to the variances of many local, city,
county and state laws, we recommend that you seek professional
legal counseling before entering into any contract or agreement.
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