Identity Theft Affidavit Forms by State

37
total templates

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.

Alabama Kansas New York
Arizona Louisiana North Carolina
California Michigan North Dakota
Colorado Minnesota Ohio
Florida Mississippi Pennsylvania
Hawaii Missouri South Carolina
Illinois Montana Texas
Indiana Nevada Virginia
Iowa New Jersey Wisconsin

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.


Related Forms and Topics:

Documents

37

Form INV ID1 "Identity Theft Affidavit" - Alabama

Rate (4.7 / 5) 18 votes
Size: 223 KB
1 page

Form CED-13 "Id Theft Complaint Form" - Nevada

Rate (4.6 / 5) 27 votes
Size: 43 KB
1 page

Arizona Form 439 "Identity Theft Affidavit" - Arizona

Rate (4.4 / 5) 19 votes
Size: 1 MB
2 pages

Form DD-014 "Identity Theft Victim Information" - Michigan

Rate (4.5 / 5) 19 votes
Size: 103 KB
3 pages

Form OCP-200 "Identity Theft Passport Application" - Montana

Rate (4.6 / 5) 16 votes
Size: 93 KB
2 pages

Form IDT-100 "Identity Theft Declaration" - New Jersey

Rate (4.4 / 5) 76 votes
Size: 121 KB
1 page

Form DTF-275 "Identity Theft Declaration" - New York

Rate (4.5 / 5) 44 votes
Size: 412 KB
1 page

Form I-381 "Identity Theft Affidavit" - South Carolina

Rate (4.5 / 5) 14 votes
Size: 1 MB
1 page

Form FTB3552 "Identity Theft Affidavit" - California

Rate (4.6 / 5) 48 votes
Size: 138 KB
2 pages

Form DR2153 "Affidavit of Colorado Driver's License or Id Theft" - Colorado

Rate (4.7 / 5) 11 votes
Size: 34 KB
2 pages

Form R-2000 "Louisiana Identity Theft Affidavit" - Louisiana

Rate (4.3 / 5) 35 votes
Size: 32 KB
1 page

Form 5593 "Identity Theft Declaration" - Missouri

Rate (4.4 / 5) 28 votes
Size: 455 KB
1 page

Form REV-1196 "Identity Theft Affidavit" - Pennsylvania

Rate (4.5 / 5) 157 votes
Size: 1 MB
3 pages

IRS Form 14039 "Identity Theft Affidavit"

Rate (4.4 / 5) 53 votes
Size: 84 KB
2 pages

Form SFN60633 "Id Theft Affidavit" - North Dakota

Rate (4.8 / 5) 11 votes
Size: 1 MB
2 pages

Form SC-AF3600.3 "Identity Theft Affidavit (Credit Card or Debt Buyer Collection Action)" - Illinois

Rate (4.5 / 5) 22 votes
Size: 382 KB
3 pages

IRS Form 14039-B "Business Identity Theft Affidavit"

Rate (4.6 / 5) 10 votes
Size: 75 KB
2 pages

"Identity Theft Victim's Complaint and Affidavit Form (Ftc Identity Theft Report)"

Rate (4.7 / 5) 30 votes
Size: 73 KB
6 pages

"Id Theft Affidavit" - Florida

Rate (4.3 / 5) 25 votes
Size: 228 KB
12 pages

"Declaration of Identity Theft" - Hawaii

Rate (4.6 / 5) 5 votes
Size: 41 KB
1 page

"Identity Theft Complaint Form" - Illinois

Rate (4.5 / 5) 17 votes
Size: 97 KB
3 pages

"Identity Theft Complaint" - Indiana

Rate (4.8 / 5) 27 votes
Size: 416 KB
3 pages

"Identity Theft Victim Application and Affidavit" - Iowa

Rate (4.7 / 5) 10 votes
Size: 90 KB
2 pages

"Identity Theft Passport Application" - Iowa

Rate (4.3 / 5) 24 votes
Size: 109 KB
2 pages

"Identity Theft Complaint Form" - Kansas

Rate (4.3 / 5) 21 votes
Size: 387 KB
4 pages

"Fraud Report Form" - Minnesota

Rate (4.5 / 5) 21 votes
Size: 7 MB
2 pages

"Fraud Identity Theft Form" - Mississippi

Rate (4.7 / 5) 25 votes
Size: 283 KB
1 page

"Id Theft Affidavit" - Mississippi

Rate (4.3 / 5) 24 votes
Size: 280 KB
6 pages

"Identity Theft Complaint Form" - Missouri

Rate (4.3 / 5) 28 votes
Size: 130 KB
4 pages

"Identity Theft Affidavit" - North Carolina

Rate (4.4 / 5) 17 votes
Size: 149 KB
13 pages

"Identity Theft Affidavit" - Ohio

Rate (4.7 / 5) 12 votes
Size: 249 KB
2 pages

"Identity Theft Intake Form" - South Carolina

Rate (4.6 / 5) 25 votes
Size: 1 MB
2 pages

"Identity Theft Affidavit" - Texas

Rate (4.8 / 5) 25 votes
Size: 230 KB
10 pages

"Id Theft Affidavit" - Virginia

Rate (4.6 / 5) 14 votes
Size: 242 KB
4 pages

"Identity Theft" - Wisconsin

Rate (4.4 / 5) 13 votes
Size: 152 KB
4 pages