#83000 – Wisconsin Claim and Declaration of Loss for Lost, Stolen, or Destroyed Credit Union Cashier’s Check or Teller’s Check (Rev. 1/20)

Use for: Certified, cashier’s or teller’s checks, when a party claims the check was lost, stolen or destroyed when governed by Wisconsin law.

• Revised 1/20.
• 8.5 x 11″, 1 copy = 1 side.
• See ii Release No. 0049 for guidance on proper use of the form.
• See: Compliance Courier – Updated declaration of loss form available (3/03/2020).