Credit Card Cardholder's Report of Lost Credit Card

Use this free form letter template to notify your credit card company that your credit card was lost or stolen and to stop all activity that takes place on the credit card.


To use this form, Copy the form text from the web page with your mouse (Ctrl+C) and paste it (Ctrl+V) into a new Microsoft Word document. Edit the blanks in the document and type in your own information. Fill in the banks and print it out and sign.

Credit Card Cardholder's Report of Lost Credit Card

Credit Card Cardholder's Report of Lost Credit Card

TO: __________(1)_____________


Since receiving the ___________(3)_____________ issued under the number __________(4)___________, it has been lost. I lost the credit card on or about _______(5)__________, _________(6)_.

The credit card was lost under the following circumstances:

(Describe Situation)

I notified ___________(7)________________ by telephone of the loss of the credit card on ________(8)___________, _______(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.



The free legal forms and information displayed in this document is designed to provide you with an example that you can follow when creating your own business legal documents. As you know, local county, city and state laws vary. Therefore, it is recommend that you seek the professional legal counsel (from an attorney) before you enter into any legal binding contract or agreement. Hoover Web Design is not responsible for any liability that comes from the use of this free legal form.

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