Identity Theft Affidavit
Identity Theft Victim’s Complaint and Affidavit A voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theft-related problems. Visit ftc.gov/idtheft to use a secure …
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www.irs.gov2. I don’t know if someone used my information to file taxes, but I’m a victim of identity theft. Provide an explanation of the identity theft issue, how it is related to your tax account, how you became aware of it and provide relevant dates. If needed, attach additional information and/or pages to this form.
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www.michigan.govSA E ICIAN RECEN IER DEPAREN AR AND ECNIC PPRUNI ERNR UNEPEN INSURANCE AENC DIRECR Autoried y UIA 6349. C 41.1 et seq. • (Rev. 03-19) • *063491903* UIA . is an equal opportunity employer/program. Statement of Identity Theft