Fillable Printable Florida's Identity Theft Victim Kit
Fillable Printable Florida's Identity Theft Victim Kit
Florida's Identity Theft Victim Kit
1
This kit is designed to help you work through the process of resolving your identity theft
case and clearing your name. While there are many general identity theft resource
guides available, this kit was specifically developed to provide assistance to Floridians
who are identity theft victims, as well as individuals in other states who had their
personal information fraudulently used in the state of Florida.
Navigating through the system as an identity theft victim can be a lengthy and confusing
process. As you contact law enforcement, creditors, and financial institutions, it is
important that you keep track of the actions you take and retain a record of your
progress.
When your identity is stolen your personal identifiers can be misused in a variety of
different ways. As soon as you become aware that your information has been misused,
there are several basic steps you should take that apply to nearly all kinds of identity
theft cases:
Step One
Report the incident to the fraud department of the three major credit bureaus.
• Ask the credit bureaus to place a "fraud alert" on your credit report.
• Order copies of your credit reports so you can review them to see if any
additional fraudulent accounts have been opened in your name or if any
unauthorized charges have been made to other accounts.
• Request a victim's statement that asks creditors to contact you prior to opening
new accounts or making changes to any existing accounts.
Contact information for the three major credit bureaus is as follows:
Florida's
Identity Theft
Victim Kit
A guide for victims of identity
theft, detailing what to do
and who to contact.
2
Equifax
P.O. Box 740241
Atlanta, GA 30374-0241
To order your report: 1-800-685-1111
To report fraud: 1-800-525-6285
TDD: 800-255-0056
www.equif ax.com
TransUnion
Fraud Victim Assistance
P.O. Box 6790
Fullerton, CA 92634-6790
Email: [email protected]
To order your report: 1-800-888-4213
To report fraud: 1-800-680-7289
TDD: 877-553-7803
www.transunion.com
Experian
P.O. Box 9532
Allen, TX 75013
To order your report: 1-888-EXPERIAN (397-3742)
To report fraud: 1-888-EXPERIAN (397-3742)
TDD: 800-972-0322
www.experian.com
Step Two
Contact the fraud department of each of your creditors.
• Gather the contact information for each of your credit accounts (credit cards,
utilities, cable bills, etc.) and call the fraud department for each creditor.
• Report the incident to each creditor, even if your account at that institution has
not been tampered with. Close the accounts that you believe have been
compromised. Ask the credit bureaus to place an "alert" on any accounts that
remain open.
• Follow-up in writing immediately. The Federal Trade Commission provides an
Identity Theft Affidavit (attached), a standardized form used to report new
accounts fraudulently opened in your name. Check with the company to see if
they accept this form. If not, request that they send you their fraud dispute form.
• Confirm all conversations in writing. Follow behind your phone call with a letter
and any necessary documentation to support your claim.
3
• Call the Federal Trade Commission at 1-877-IDTHEFT (438-4338) and request a
copy of their brochure "Identity Crime: When Bad Things Happen to Your Good
Name." This brochure contains sample dispute letters to help get you started as
well as more information on resolving credit problems. The brochure is also
available through the Federal Trade Commission website at www.ftc.gov
Step Three
Contact your bank or financial ins t itution.
• If your checks have been stolen, or if you believe they have been used, contact
your bank or credit union and stop payment right away.
• Put stop payments on any outstanding checks that you are unsure about.
• Contact the major check verification companies and request they notify retailers
who use their databases not to accept your checks:
TeleCheck 1-800-710-9898 or 927-0188
Cetergy, Inc 1-800-437-5120
International Check Services 1-800-631-9656
• Call SCAN at 1-800-262-7771 to learn if bad checks have been passed in your
name.
• If you suspect your accounts have been compromised, cancel your checking and
savings accounts and obtain new account numbers.
Step Four
Report the incident to law enforcement.
• Contact your local police department or sheriffs office to file a report. Under
Florida Statute 817.568, the report may be filed in the location in which the
offense occurred, or, the city or county in which you reside.
• When you file the report, provide as much documentation as possible, including
copies of debt collection letters, credit reports, and your notarized ID Theft
Affidavit.
• Request a copy of the police report. Some creditors will request to see the report
to remove the debts created by the identity thief.
4
What Else Can I Do?
File a complaint with the FTC's Identity Theft Clearinghouse
The Clearinghouse is the federal government's repository for ID theft complaints.
Complaint information is entered into a central database, the Consumer Sentinel,
which is accessed by many local and state law enforcement agencies in Florida,
as well as Florida's Attorney General, for identity theft investigation. Call the toll-
free hotline at 1-877-IDTHEFT.
Flag your Florida Driver's License.
At your request, the Fraud Section of the Department of Highway Safety and
Motor Vehicles (DHSMV) will place a flag on your driver's license if you are a
victim of identity theft (regardless of whether your Florida Driver's License has
been compromised). To reach the Fraud Section, call (850) 617-2405. You will
be asked to submit your request in writing to:
Department of Highway Safety and Motor Vehicles
DDL/BDI - Fraud Section, Room A327
Neil Kirkman Building
Tallahassee, FL 32399-0570
If you believe that the identity thief has actually used your personal information to
secure a Florida Driver's License or Identification Card, DSHMV will conduct a
fraud investigation. To initiate this investigation, request a DHSMV Identity Theft
Report Form and mail it to the address above. The form is also available through
the DHSMV website at www.hsmv.state.fl.us
Get assistance through Florida's Fraud Hotline.
Florida's Attorney General provides a toll-free fraud hotline for Floridians who are
the victims of Fraud. Contact the hotline at 1-866-9-NO -SCAM (1-866-966-7226).
Trained advocates can help provide additional resource information in your area.
Check your Florida criminal histor y information.
In some instances of identity theft, a victim may be faced with a criminal record
for a crime he or she did not commit. The Florida Department of Law
Enforcement (FDLE) can provide a Compromised Identity Review (based on a
fingerprint comparison of state criminal history files) to determine what, if any,
criminal history belongs to you, and if any arrest records have been falsely
associated with you as a result of someone using your identity. If a fingerprint
check determines you are an identity theft victim, FDLE will work with local law
enforcement agencies to attempt to clear fraudulent data from the criminal history
files and provide you with a Compromised Identity Certificate. For more
information, contact FDLE's Quality Control Section at (850) 410-8880 or visit
www.fdle.state.fl.us
5
Contact the Florida Department of Law Enforcement.
After you have filed a report with local law enforcement and with the FTC's
Identity Theft Clearinghouse, you may contact FDLE. FDLE Special Agents who
work identity theft cases may be able to provide additional guidance and
assistance. Check your phone book to find the nearest FDLE Regional
Operations Center or visit www.fdle.state.fl.us
Remove your personal identifiers from Florida court records.
Any person has the right to request the Clerk or County Recorder to
redact/remove his or her Social Security number, bank account number, credit,
debit or charge card number from an image or copy of an Official Record that has
been placed on such Clerk's/County Recorder's publicly available Internet
website, or in a court file. If you believe your personal information appears in a
publicly available record, contact your County Clerk's Office to initiate a request.
A listing of all County Clerks can be found at www.flcler ks.com
Report Mail Theft to the U.S. Postal Inspection Service.
The U.S. Postal Inspection Service will investigate if your mail has been stolen by
an identity thief and used to obtain new credit or commit fraud. Incidents should
be reported to your nearest U.S. Postal Inspection Service district office. Check
your telephone book for your local office or visit www.usps.com
Report Passport Fraud to the U.S. Department of State.
If your passport is lost or stolen, or you believe it is being used fraudulently,
contact your local Department of State field office. Check your telephone book
for your local office or visit www.state.gov
Protect your Social Securit y number.
The Social Security Administration can verify the accuracy of the earnings
reported on your social security number. To check for inaccuracies or fraud,
order a copy of your Personal Earnings and Benefit Estimate Statement (PEBES)
from the Social Security Administration by calling 1-800-772-1213 or visiting
www.ssa.gov
Instructions for
Completing the ID Theft Affidavit
To make certain that you do not become
responsible for the debts incurred by the identity
thief, you must provide proof that you didn’t
create the debt to each of the companies where
accounts were opened or used in your name.
A working group composed of credit grant-
ors, consumer advocates and the Federal Trade
Commission (FTC) developed this ID Theft
Affidavit to help you report information to many
companies using just one standard form. Use of
this affidavit is optional. While many companies
accept this affidavit, others require that you
submit more or different forms. Before you send
the affidavit, contact each company to find out if
they accept it.
You can use this affidavit where a new ac-
count was opened in your name. The information
will enable the companies to investigate the fraud
and decide the outcome of your claim. (If some-
one made unauthorized charges to an existing
account, call the company to find out what to
do.)
This affidavit has two parts:
• ID Theft Affidavit is where you report general
information about yourself and the theft.
• Fraudulent Account Statement is where
you describe the fraudulent account(s) opened
in your name. Use a separate Fraudulent Ac-
count Statement for each company you need to
write to.
When you send the affidavit to the compa-
nies, attach copies (NOT originals) of any support-
ing documents (e.g., drivers license, police report)
you have.
Before submitting your affidavit, review the
disputed account(s) with family members or
friends who may have information about the
account(s) or access to them.
Complete this affidavit as soon as pos-
sible. Many creditors ask that you send it within
two weeks of receiving it. Delaying could slow the
investigation.
Be as accurate and complete as possible.
You may choose not to provide some of the
information requested. However, incorrect or
incomplete information will slow the process of
investigating your claim and absolving the debt.
Please print clearly.
When you have finished completing the
affidavit, mail a copy to each creditor, bank or
company that provided the thief with the unautho-
rized credit, goods or services you describe.
Attach to each affidavit a copy of the Fraudulent
Account Statement with information only on
accounts opened at the institution receiving the
packet, as well as any other supporting documen-
tation you are able to provide.
Send the appropriate documents to each
company by certified mail, return receipt
requested, so you can prove that it was received.
The companies will review your claim and send
you a written response telling you the outcome of
their investigation. Keep a copy of everything
you submit for your records.
If you cannot complete the affidavit, a legal
guardian or someone with power of attorney may
complete it for you. Except as noted, the informa-
tion you provide will be used only by the company
to process your affidavit, investigate the events
you report and help stop further fraud. If this
affidavit is requested in a lawsuit, the company
might have to provide it to the requesting party.
Completing this affidavit does not guarantee
that the identity thief will be prosecuted or that
the debt will be cleared.
ID Theft Affidavit
Name __________________________________ Phone number _______________________ Page 1
Victim Information
(1) My full legal name is ___________________________________________________________
(First) (Middle) (Last) (Jr., Sr., III)
(2) (If different from above) When the events described in this affidavit took place, I was known as
____________________________________________________________________________
(First) (Middle) (Last) (Jr., Sr., III)
(3) My date of birth is ____________________
(day/month/year)
(4) My social security number is________________________________
(5) My driver’s license or identification card state and number are__________________________
(6) My current address is __________________________________________________________
City ___________________________ State _________________ Zip Code ______________
(7) I have lived at this address since _____________________________
(month/year)
(8) (If different from above) When the events described in this affidavit took place, my address
was_________________________________________________________________________
City ___________________________ State _________________ Zip Code ______________
(9) I lived at the address in #8 from __________ until __________
(month/year) (month/year)
(10) My daytime telephone number is (____)____________________
My evening telephone number is (____)____________________
How the Fraud Occurred
Check all that apply for items 11 - 17:
(11) ❑
I did not authorize anyone to use my name or personal information to seek the money,
credit, loans, goods or services described in this report.
(12) ❑
I did not receive any benefit, money, goods or services as a result of the events described
in this report.
(13) ❑My identification documents (for example, credit cards; birth certificate; driver’s license;
social security card; etc.) were ❑ stolen
❑ lost
on or about ____________________.
(day/month/year)
(14) ❑To the best of my knowledge and belief, the following person(s) used my information (for
example, my name, address, date of birth, existing account numbers, social security number, mother’s
maiden name, etc.) or identification documents to get money, credit, loans, goods or services without
my knowledge or authorization:
_________________________________ _____________________________________
Name (if known) Name (if known)
_________________________________ _____________________________________
Address (if known) Address (if known)
_________________________________ _____________________________________
Phone number(s) (if known) Phone number(s) (if known)
_________________________________ ____________________________________
additional information (if known) additional information (if known)
_________________________________ _____________________________________
_________________________________ _____________________________________
(15) ❑ I do NOT know who used my information or identification documents to get money,
credit, loans, goods or services without my knowledge or authorization.
(16) ❑
Additional comments: (For example, description of the fraud, which documents or
information were used or how the identity thief gained access to your information.)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
_____________________________________________________________________________________
____________________________________________________________________________________
(Attach additional pages as necessary.)
Name __________________________________ Phone number _______________________ Page 2
Victim’s Law Enforcement Actions
(17)(check one) I ❑ am ❑ am not willing to assist in the prosecution of the person(s) who
committed this fraud.
(18)(check one) I ❑ am ❑ am not authorizing the release of this information to law enforce-
ment for the purpose of assisting them in the investigation and prosecution of the person(s) who com-
mitted this fraud.
(19)(check all that apply) I ❑ have ❑ have not reported the events described in this affidavit
to the police or other law enforcement agency. The police ❑ did ❑ did not write a report.
In the event you have contacted the police or other law enforcement agency, please complete the following:
_____________________________ _________________________________
(Agency #1) (Officer/Agency personnel taking report)
____________________________ _________________________________
(Date of report) (Report Number, if any)
_____________________________ _________________________________
(Phone number) (e-mail address, if any)
_____________________________ _________________________________
(Agency #2) (Officer/Agency personnel taking report)
_____________________________ _________________________________
(Date of report) (Report Number, if any)
_____________________________ _________________________________
(Phone number) (e-mail address, if any)
Documentation Checklist
Please indicate the supporting documentation you are able to provide to the companies you plan to
notify. Attach copies (NOT originals) to the affidavit before sending it to the companies.
(20)
❑
A copy of a valid government-issued photo-identification card (for example, your
driver’s license, state-issued ID card or your passport). If you are under 16 and don’t have a photo-ID,
you may submit a copy of your birth certificate or a copy of your official school records showing your
enrollment and place of residence.
(21)
❑ Proof of residency during the time the disputed bill occurred, the loan was made or the
other event took place (for example, a rental/lease agreement in your name, a copy of a utility bill or a
copy of an insurance bill).
Name __________________________________ Phone number _______________________ Page 3
(22)
❑
A copy of the report you filed with the police or sheriff’s department. If you are unable
to obtain a report or report number from the police, please indicate that in Item 19. Some companies
only need the report number, not a copy of the report. You may want to check with each company.
Signature
I declare under penalty of perjury that the information I have provided in this affidavit is true and
correct to the best of my knowledge.
_______________________________________ __________________________________
(signature) (date signed)
Knowingly submitting false information on this form could subject you to criminal
prosecution for perjury.
______________________________________
(Notary)
[Check with each company. Creditors sometimes require notarization. If they do not, please have one
witness (non-relative) sign below that you completed and signed this affidavit.]
Witness:
_______________________________________ __________________________________
(signature) (printed name)
_______________________________________ __________________________________
(date) (telephone number)
Name __________________________________ Phone number _______________________ Page 4
I declare (check all that apply):
❑ As a result of the event(s) described in the ID Theft Affidavit, the following account(s) was/were
opened at your company in my name without my knowledge, permission or authorization using my
personal information or identifying documents:
Completing this Statement
• Make as many copies of this page as you need. Complete a separate page for each
company you’re notifying and only send it to that company. Include a copy of your
signed affidavit.
• List only the account(s) you’re disputing with the company receiving this form. See the
example below.
• If a collection agency sent you a statement, letter or notice about the fraudulent account,
attach a copy of that document (NOT the original).
Fraudulent Account Statement
Creditor Name/Address
(the company that opened the
account or provided the goods or
services)
Account
Number
Type of unauthorized
credit/goods/services
provided by creditor
(if known)
Date
issued or
opened (if
known)
Amount/Value
provided
(the amount
charged or the
cost of the
goods/services)
❑ During the time of the accounts described above, I had the following account open with your company:
Billing name ________________________________________________________________________
Billing address ______________________________________________________________________
Account number ____________________________________________________________________
Example
Example National Bank
22 Main Street
Columbus, Ohio 22722
01234567-89 auto loan 01/05/2000 $25,500.00
Name __________________________________ Phone number _______________________ Page 5
