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Identity Theft Complaint Form

Identity theft has become such a common crime but it is a violation of your personality.  It tarnishes your name and is a form of fraud.  It is vital that you report this crime immediately.  You need to fill out an identity theft complaint form especially incase of a lawsuit.

Name: __________________________________________________________________

Address: ________________________________________________________________

Tel: ____________________________________________________________________

Mobile: ___________________________________________________________________

Email: __________________________________________________________________

Date your identity was stolen: _______________________________________________

How did you discover your identity had been stolen? _____________________________

_______________________________________________________________________

Describe purchases or transactions made with your stolen identity:

Purchase/transaction        Date

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

Give details of any suspects you might consider responsible of this crime:

Name     Relationship   Location

__________________________ ____________________ __________________

__________________________ ____________________ __________________

__________________________ ____________________ __________________

__________________________ ____________________ __________________

__________________________ ____________________ __________________

Name companies/ organizations you have informed about your stolen identity:

Name          Date

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

________________________________________________________ ____________

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