Affidavit of Company Badge Loss
I,
, employed by
, hereby declare the following:
1. Badge Details
Badge Number:
Department:
Position/Title:
2. Date and Circumstances of Loss
Date Lost:
Place of Loss:
Description of Circumstances:
I affirm that to the best of my knowledge, the information provided above is true and correct. I understand that any false statement may lead to disciplinary action in accordance with company policies.
Date: