Identity Theft Affidavit Forms by State

What Is an Identity Theft Affidavit?

An Identity Theft Affidavit is a document that an individual is supposed to fill in and file in case they have obtained information that their personal data was used to create an illegitimate account or perform any other actions from their name. The purpose of the form is to help victims of identity theft recover from it and report it.

An Affidavit of Identity Theft form is used by different government organizations, such as the Internal Revenue Service (IRS) (Form 14039 and Form 14039-B), Federal Trade Commission (FTC) (FTC Identity Theft Victim's Complaint and Affidavit), the State Department of Taxation in different states, etc. Even though they all use a different form to report identity theft, they all contain similar information.

You can download an Identity Theft Affidavit through the links below.

AlabamaKansasNew York
ArizonaLouisianaNorth Carolina
CaliforniaMichiganNorth Dakota
ColoradoMinnesotaOhio
FloridaMississippiPennsylvania
HawaiiMissouriSouth Carolina
IllinoisMontanaTexas
IndianaNevadaVirginia
IowaNew JerseyWisconsin

How to Create an Identity Theft Affidavit?

After a filer suspects that they have become a victim of identity theft they should contact the business or government organization where the theft took place, to find out the actions they need to perform to recover from it and what kind of a document they will accept. Most organizations accept the FTC Identity Theft Affidavit, however, some entities use their own forms, like IRS Identity Theft Affidavit.

The affidavit should consist of several parts, which include the following:

  1. Personal information. Here a victim should designate their full name and social security number to identify themselves.
  2. Contact information. An applicant should state their full current mailing address (including apartment number, zip code, or PO box) and telephone number.
  3. Information about the incident. If an individual has any information about the identity theft that took place, they should report it here. For example, the year when the incident occurred.
  4. Signature and date. Filers use this part of the form to put their signature and date.
  5. Information about the victim’s representative. In the last part of the document, an applicant should enter the information about the representative (if they have one). Here they should mention their full name, current mailing address, and telephone number.

Where Do I Mail My Identity Theft Affidavit?

After receiving instructions from the company where the theft took place, a filer should mail them and the FTC an Identity Theft Affidavit. To create an FTC Identity Theft Affidavit an applicant should visit the official website of the FTC, where they can fill it in and submit it online.

If a filer wants to report tax fraud they should use IRS Form 14039, Identity Theft Affidavit. After completing it, they should mail it to the IRS. The IRS’s mailing address instructions are provided in the form. The address itself will depend on the situation the filer reported in the document.

If a filer wants to report a state’s tax report, they should visit the official website of the state’s Department of Taxation. There, they can find the requirements for the affidavit and the mailing address.


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Documents:

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This form is used for reporting incidents of identity theft in the state of California. It is used to provide information and support in resolving any issues related to identity theft.

This document is a form used in Nevada to file a complaint for identity theft.

This document is used for reporting identity theft in South Carolina. It allows individuals to provide information about the theft and its impact on themselves and their financial accounts.

This form is used for reporting and documenting cases of identity theft in South Carolina. It helps gather information about the incident and assists law enforcement agencies in their investigations.

This document is used for reporting and seeking assistance as a victim of identity theft in Iowa. It includes an application and affidavit to be filled out by the victim to provide necessary information for investigation and resolution of the identity theft case.

This form is used for reporting identity theft incidents in the state of Texas. It allows victims to provide a detailed account of the theft and request assistance from law enforcement agencies.

This form is used for applying for an Identity Theft Passport in the state of Iowa. It is a document that helps victims of identity theft protect their identity and prevent further fraud.

This document provides information and resources about identity theft in the state of Wisconsin. It includes steps to prevent identity theft and instructions for reporting and recovering from this crime.

This form is used for reporting identity theft and providing information to the state of Michigan.

This form is used for reporting cases of identity theft and providing necessary information to law enforcement authorities in Arizona.

This Form is used for reporting identity theft and providing information to the authorities in North Dakota.

This form is used for reporting identity theft in North Carolina. It allows individuals to provide a detailed account of the fraudulent activity and helps law enforcement in their investigation.

This form is used for applying for an identity theft passport in Montana. It helps individuals protect their identity and prevent any further unauthorized use of their personal information.

This form is used for reporting identity theft and submitting a sworn statement in Minnesota.

This form is used for reporting identity theft incidents in the state of Missouri. It allows individuals to file a complaint and provide necessary information to law enforcement authorities.

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