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