Free Cardholder's Report Of A Stolen Credit Card Form free for you to use

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TO: ______________________


Since receiving the _______________________ issued under the number _____________________, it has been stolen. The card was stolen on or about ___________, 20___.

The card was stolen under the following circumstances:

(Describe Situation)

I notified ___________________________ by telephone of the theft of the card on ____________________, 20___.

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 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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