ID Theft Affidavit

ID Theft Affidavit

[Your Name]

[Your Address]

[Your Email]

[Date]

[Recipient's Name]

[Recipient's Title]

[Recipient's Company Name]

[Recipient's Company Address]

Subject: ID Theft Affidavit for Reporting Unauthorized Transactions

To Whom It May Concern,

I, [Your Name], residing at [Your Address], hereby solemnly affirm the following information to report unauthorized transactions and activities related to identity theft:

Personal Information:

  1. Full Name: [Your Name]

  2. Date of Birth: [Your Birthdate]

  3. Social Security Number (SSN): [Your SSN]

  4. Driver's License Number (if applicable): [Your Driver's License Number]

Description of Unauthorized Transactions:

  1. [Date(s) of Unauthorized Transaction(s)]

  2. Nature of Unauthorized Transactions:

  • Unauthorized credit card charges totaling [Amount] made at [Store Name] on [Date].

  • Unauthorized bank transfer of [Amount] from my checking account to an unknown account on [Date].

Description of Steps Taken:

  1. Actions Taken to Discover Unauthorized Transactions: I discovered the unauthorized transactions when reviewing my bank and credit card statements online on [Date]. The charges were not made by me, and I immediately realized that I was a victim of identity theft.

  2. Actions Taken with Relevant Financial Institutions or Service Providers: I contacted my bank and credit card company on [Date], to report the unauthorized transactions. I informed them of the fraudulent charges and requested that they freeze my accounts and initiate investigations into the matter.

  3. Any Police Reports Filed: Yes, I filed a police report with the [Police Department Name] on [Date]. The case number is [Case Number].

Affirmation:

I, [Your Name], declare under penalty of perjury that the information provided in this ID Theft Affidavit is true and accurate to the best of my knowledge and belief. I understand that providing false information may result in legal consequences.

If further information is required, I can be reached at the following contact details:

Email Address: [Your Email]

Phone Number: [Your Phone Number]

[Your Name]

[Date]

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