Affidavit and Indemnity Bond

Purpose of Form

If your refund check has been lost, destroyed or stolen, submit the Affidavit and Indemnity Bond form at the bottom of this page to initiate the process of getting a new check.

How to Complete the Form

You will need the following information to complete the form:

  • Current address
  • Social Security Number or FEIN
  • Tax Year
  • Check Number and Check Date (You can find this information by using the Where’s My Refund tool or by calling the Department)

Notarize the Form

You must complete two original copies of the affidavit before a Notary Public.

If the affidavit is not returned in duplicate, notarized, or is incomplete it will be considered invalid and will not be processed, further delaying receipt of your refund.

How to Submit the Form

Return both of the completed, notarized affidavits to:

Customer Service

Post Office Box 1168

Raleigh, NC 27602-1168


 Please allow 60 days for the Department to issue your replacement check.

  • If a stop payment is required, another check is usually issued within 30 to 60 days after the Department receives your completed affidavit in duplicate.
  • If your check has been cashed by someone else, forgery proceedings will take at least 120 days to be completed.
  • If you receive your refund check after you have mailed your letter or completed affidavit requesting a replacement check, do not cash the check. Instead, return the check to the NC Department of Revenue.

Still Have Questions?

Contact a NCDOR agent at 1-877-252-4052. 

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