Free ID Theft Affidavit Template
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:
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Full Name: [Your Name]
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Date of Birth: [Your Birthdate]
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Social Security Number (SSN): [Your SSN]
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Driver's License Number (if applicable): [Your Driver's License Number]
Description of Unauthorized Transactions:
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[Date(s) of Unauthorized Transaction(s)]
-
Nature of Unauthorized Transactions:
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Unauthorized credit card charges totaling [Amount] made at [Store Name] on [Date].
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Unauthorized bank transfer of [Amount] from my checking account to an unknown account on [Date].
Description of Steps Taken:
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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.
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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.
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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]
