Fillable and printable identity theft affidavit 2020. More than just a template, our stepbystep interview process makes it easy to create an ftc identity theft complaint. In the vast majority of taxrelated identity theft cases, there is no need to file the form 14039 affidavit. Take full advantage of a digital solution to develop, edit and sign contracts in pdf or word format on the web. If someone is using your personal information to open new accounts, make purchases, or get a tax refund, report it at identitytheft. File a police report about the identity theft, and get a copy of the police report or the report number. The id theft affidavit provides a model form that can be used to report information to many companies, simplifying the process of alerting companies where a new account was opened in the victims name. Identity theft affidavit pennsylvania office of attorney. A voluntary form for filing a report with law enforcement and disputes with credit reporting agencies and creditors about identity theftrelated problems. A voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theftrelated problems. Ftc identity theft affidavit oklahoma state bureau of. Dec 31, 2019 taxpayers who experience taxrelated identity theft may wonder when they should file a form 14039, identity theft affidavit.
For victims of identity theft, getting an identity theft report makes it easier to fix problems that an identity thief has caused. The affidavit requests information regarding you as the victim, how the fraud occurred, law enforcements actions. When you finish writing all the details, print a copy of the report. Before you report identity theft to the ftc, first contact your bank or and other. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Form 14039 omb number identity theft affidavit 154529. State of california identity theft team ms a232 franchise tax board po box 2952 sacramento ca 958122952 identity theft affidavit complete and submit this form if you are an actual or potential victim of identity theft and would like the franchise. This is the same affidavit that the ftc makes available to victims of identity theft. State of california identity theft team ms a232 franchise tax board po box 2952 sacramento ca 958122952 identity theft affidavit complete and submit this form if you are an actual or potential victim of. The ftc has overhauled the process for helping victims of identity theft. The ftc unveiled a new tool today to assist victims of identity theft restore their good names.
The enclosed identity theft victims complaint and affidavit completed with all relevant information regarding the alleged identity theft crime. Fill out, securely sign, print or email your ftc identity theft form instantly with signnow. Pdf editor enables you to make modifications to your ftc identity theft victims complaint and affidavit fill online from any internet linked gadget, customise it in line with your requirements, sign it electronically and distribute in different ways. Check with the company to see if they accept this form. Identity theft affidavit fill online, printable, fillable. An identity theft affidavit includes personal and account information, and is a statement of the facts surrounding your identity theft. Reporting identity theft to the federal trade commission ftc is a critical step toward protecting yourself and your finances when youve been a victim. If you create an account, well walk you through each recovery step, update your plan as needed. Fill out blanks, sign, edit and print templates instantly in your personal account. Instructions and help about ftc affidavit pdf form. Thankfully, the ftc has created an online ftc complaint assistant to help you easily submit a report. Omb number 154529 complete this form if you need the irs to mark an account to identify questionable activity. Identity theft affidavit fill online, printable, fillable, blank pdffiller. Identity theft clearinghouse, federal trade commission, 600 pennsylvania avenue, when you open new accounts, use new nw, washington, dc 20580.
Irs has issued several recent consumer warnings on the fraudulent use of the irs name or logo by scamsters. Include a copy of the federal form 14039 identity theft affidavit, if required by the irs to be completed. Visit ftcgovidtheft to use a secure online version that you can. You may not need the id theft affidavit to absolve you of debt resulting from identity theft if you obtain an identity theft report. Video instructions and help with filling out and completing ftc identity theft victims.
An identity theft affidavit is a notarially certified document certifying that the person has become a victim of fraud with personal data. Identity theft affidavit ohio department of taxation. Complete and submit this form if you are an actual or potential victim of identity theft and would like the franchise tax board ftb to update your account status to identify questionable activity. Submit an identity theft complaint affidavit with the ftc the federal trade commission ftc is the nations consumer protection agency that collects identity theft information.
Fill, sign and download identity theft affidavit online on. Section a check the following boxes in this section that apply to the specific situation you are reporting required for all filers 1. December 2011 please complete and submit this form if you are an actual or potential victim of identity theft and would like the irs to mark your account to identify any questionable activity. The federal trade commission has created a userfriendly identity theft affidavit form known as the ftcs identity theft report that victims. Complete and submit this form if you are an actual or potential victim of identity theft and would like the franchise tax board ftb to update your account status to identify. Mar 11, 2019 in a nutshell the federal trade commission has created a userfriendly identity theft affidavit form known as the ftcs identity theft report that victims can complete online to document the facts surrounding their identity theft. Turn them into templates for numerous use, incorporate fillable fields to collect recipients. The most secure digital platform to get legally binding, electronically signed documents in. You can go to to report identity theft and get a recovery plan.
This information also may be shared with other government agencies, consumer reporting agencies, and companies where the fraud was perpetrated to help resolve identity theft related problems. The ftc collects complaints from identity theft victims and shares their information with law enforcement nationwide. Call 1877idtheft 18774384338 to request the ftc identity theft report. Save, sign, print, and download your document when you are done. Your completed complaint is called an ftc affidavit. Contact their financial institutions to close any financial or credit accounts opened without permission or that were tampered with by identity thieves.
Obtain an identity theft fraud and forgery declaration form from your chase branch or from any financial institution. Ftc federal trade commission identity theft affidavit a copy of the ftc identity theft affidavit can be found at the end of this packet. Federal trade commission announces id theft affidavit. The form will serve as a documented report of the victim which will inform the authorities about the incident and situation that the victim is currently involved in. An identity theft affidavit form is a document which is required to be filled out and submitted by individuals who have been a victim of identity thieves. The federal trade commission ftc is the central federal government agency responsible for identity theft awareness.
The id theft affidavit provides a model form that can be used to report information to many companies. Red flags of identity theft federal trade commission. Do not send affidavit to the ftc or any other government agency affidavit updated 0405 identity theft affidavit victim information 1. You are receiving this information because you have notified a consumer reporting agency that you believe that you are a victim of identity theft. Turn them into templates for numerous use, incorporate fillable fields.
Identity theft affidavit i believe that i have been a victim of identity theft. According to the federal bureau of investigation and the national association of attorneys general, id theft has become one of the nations fastestgrowing crimes. About identity theft if someone is using your personal or financial information to make purchases, get benefits, file taxes, or commit fraud, thats identity theft. All without detailed information about the crime, we may not be fields on this form are required. The federal trade commission s receives about 4,000 identity theft complaints per week. This information also may be shared with other government agencies. Identity theft victims complaint and affidavit pdf pdf. Contact the following organizations to notify them that your identity was stolen. You may not need the id theft affidavit to absolve you of debt resulting from identity theft if you obtain an. Personal identification numbers pins and do not send affidavit to the ftc or any other government agency. When to file a form 14039, identity theft affidavit.
Identity theft report fill out and sign printable pdf. Identity theft victims complaint and affidavit a voluntary form for filing a report with law enforcement and disputes with credit reporting agencies and creditors about identity theftrelated problems. The identity theft affidavit provides the appropriate information for businesses and creditors, which is necessary in order to prevent or minimize damage from malicious actions. A voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors. Form 14039 identity theft affidavit internal revenue service. Report identity theft to the ftc identity theft recovery steps. File a police report with your local police department. The identity theft affidavit provides the appropriate information for. Lake county sheriffs office identity theftfraud packet. Jan 26, 2020 reporting identity theft to the federal trade commission ftc is a critical step toward protecting yourself and your finances when youve been a victim. Jun 23, 2018 an identity theft affidavit is a document that can help victims of identity theft prove to a business that their personal financial data has been used to open a fraudulent account. Complete the identity theft report online at the website of the federal trade commission ftc at identitytheft. This is the same affidavit that the ftc makes available to victims of.
Leave 3 blank until you provide this form to someone with a legitimate business need, like when you are filing your report at the. If different from above when the events described in this affidavit took place, i was known as first middle last jr. Identity theft victim s complaint and affidavit a voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theftrelated problems. We will use the information you provide to create your. Someone has used my personal information to set up an account without my authorization. Identity theft victims complaint and affidavit a voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theftrelated problems. Identity theft affidavit catalog number 52525a omb number 154529 form 14039 rev. A voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theft related problems. These will help you fix problems caused by the identity theft. Free ftc identity theft complaint free to print, save. Create your identity theft report by combining your ftc identity theft affidavit with. Id theft affidavit do not send affidavit to the ftc o an othe govenment agency page 1 name phone number victim information 1. Section a check the following boxes in this section that. Creating an identity theft report involves 3 steps.
Complete irs form 14039, identity theft affidavit pdf. If youre dealing with tax, medical, or child identity theft, read special forms of identity theft. The federal trade commission provides an identity theft affidavit attached, a standardized form used to report new accounts fraudulently opened in your name. If not, request that they send you their fraud dispute form. If you choose not to file a complaint with the ftc an identity theft affidavit can be found at the end of this packet, however, filing an ftc complaint and submitting a copy to the sheriffs office is the. Instructions for completing the id theft affidavit do not send. Heres stepbystep advice that can help you limit the damage, report identity theft, and fix your credit. An identity theft affidavit is a document that can help victims of identity theft prove to a business that their personal financial data has been used to open a fraudulent account. The ftcs identity theft affidavit, which helps with documenting fraudulent activity, is a crucial step in the identity theft recovery process. Submit an identity theft complaintaffidavit with the ftc the federal trade commission ftc is the nations consumer protection agency that collects identity theft information.
Respond immediately to any irs notice and call the number provided in the letter. Easily submit ftc identity theft affidavit online in pdf and word formats. Ftc identity theft affidavit printable and editable pdf. This booklet can guide you through the recovery process. We suggest you consider obtaining an identity theft report where a new account was opened in your name. Federal trade commission announces id theft affidavit federal.