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Rev 04/08 Mastercard Account # Visa Account # AFFIDAVIT OF UNAUTHORIZED USE Important: The person alleging forgery / unauthorized use must complete this form in longhand. 1. I am first duly sworn.

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How to fill out the affidavit of unauthorized use online

Filling out the affidavit of unauthorized use is an important step in reporting unauthorized transactions on your credit card. This guide will help you navigate the process online, ensuring that all necessary information is accurately provided. Follow the instructions carefully to complete your affidavit and protect your financial interests.

Follow the steps to fill out the affidavit online:

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by providing your personal information in the designated fields. This includes your full name, mailing address, city, state, and zip code. Ensure that all details are accurate to facilitate communication regarding your affidavit.
  3. Next, enter your home and work phone numbers. Be sure to include area codes.
  4. Indicate the date of the first fraudulent transaction and where it took place. This information is crucial for the investigation.
  5. Affirm that all transactions listed were unauthorized and not signed by you. You must also state that you did not give anyone permission to use your card.
  6. Report the number of cards issued to you and the financial institution that provided them.
  7. State whether you had possession of the card during the fraudulent transactions and provide any pertinent details regarding its status.
  8. Select how you discovered that the card was lost, stolen, or never received and provide the date you reported it to the relevant authorities.
  9. Declare that you did not benefit from the fraudulent transactions and understand the purpose of this affidavit.
  10. Indicate if you reported the issue to law enforcement, providing details such as the police department and case number if applicable.
  11. Acknowledge that the matter may be subjected to investigation and that you may need to provide testimony if required.
  12. Make sure to understand and acknowledge the legal implications of providing false information in your affidavit.
  13. Finally, sign the affidavit where indicated for the primary cardholder, secondary cardholder, and any authorized users. Ensure that the date is also included.
  14. After completing all sections of the affidavit, review your entries for accuracy. You can then save changes, download, print, or share the completed form as needed.

Complete your affidavit of unauthorized use online today to protect your account.

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Finally, since an affidavit is an official statement, you'll need to declare whether you authorized anyone to use your information, whether you benefited in any way from the fraud, and whether you are willing to work with law enforcement if charges are brought against anyone found to have stolen your identity.

This affidavit has two parts: Part One — the ID Theft Affidavit — is where you report general informa- tion about yourself and the theft. Part Two — the Fraudulent Account Statement — is where you describe the fraudulent account(s) opened in your name.

The FTC provides an ID Theft Affidavit to help victims of identity theft quickly and accurately dispute new unauthorized accounts. It is especially helpful in cases where consumers are unable to file or obtain a police report. Some creditors will accept this affidavit instead of a police report.

The wording of an affidavit is in the following format: Write the heading “AFFIDAVIT”. State your name and personal details (i.e. ID number, gender, address, contact details, etc.). State that you are making a declaration under oath (i.e. “I, the undersigned, declare the following under oath”).

Send copies of your police report and completed ID Theft Affidavit. Remind the credit bureaus that they must block or remove any information that you, as an identity theft victim, say is a result of the theft. Send your letters by certified mail, return receipt requested. Keep a copy of each letter.

I am a victim of identity theft. I recently learned that my personal information was used to open an account at your company. I did not open or authorize this account, and I therefore request that it be closed immediately.

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