Indemnity Re: Lost or Stolen Check
TO: Full Name of Person Issuing Cheque
Reference is made to a check dated Date of Lost or Stolen Cheque in the amount of $Amount of Lost or Stolen Cheque issued by Full Name of Person Issuing Cheque (the “Payor”) in favour of Full Name of Person to whom Cheque was made out to (the “Payee”) bearing check no. Cheque Number (if available) (the “Original Check”), which Original Check has been lost, mislaid, stolen, or destroyed, so that the same cannot be found or produced.
In consideration for the Payor re-issuing a check in the same amount to the Payee (the “Replacement Check”) without calling for the surrender or cancellation of the Original Check, the Payee hereby agrees to indemnify and save harmless the Payor from and against any actions, whether groundless or otherwise, and from and against any losses, damages, costs and liabilities whatever, which the Payor at any time shall or may incur: 1. 2. 3. by reason of the issuance and delivery of the Replacement Check; or by reason of any claim which may be made in respect of the Old Check; or by reason of any payment, transfer, exchange or other act which the Payor may make or do in respect of the Old Check, whether made or done through accident, oversight, or neglect, or whether made or done upon presentation thereof without contesting the propriety of the payment, transfer, exchange or other act; or by reason of any other matter or thing arising out of the replacement of the Original Check with the Replacement Check.
4.
DATED: Date of Signing of Indemnity
Witness
Full Name of Person to whom Cheque was made out to