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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.

You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224.

The FTC's ID Theft Affidavit is intended to simplify this process. Instead of completing different forms, consumers can use the ID Theft Affidavit to alert companies when a new account was opened in the identity theft victim's name.

Filing Form 14039, Identity Theft Affidavit It can be completed online, printed and attached to a paper tax return for mailing to the IRS. Or taxpayers may complete the form online at the Federal Trade Commission and the FTC will electronically transfer the Form 14039 ? but not the tax return ? to the IRS.

File an official identity theft report with the Federal Trade Commission (FTC). Filing a report with the FTC gives you an official identity theft affidavit to help dispute charges and repair your credit. Head to .IdentityTheft.gov to file a report. Contact your bank to change your account and card numbers.

Fill Out the FTC's ID Theft Affidavit. Report your identity theft matter to the FTC. Fill out the FTC ID Theft Affidavit completely and accurately. Submit a copy of the affidavit to creditors who agree to accept it instead of a police report or instead of the creditor's own affidavit form.

You should fill out the FTC's online form if and whenever you learn that you've been a victim of identity theft. The IRS has its own identity theft affidavit to complete if your identity ? specifically your Social Security number ? is used to file a fraudulent federal tax return.

Visit ftc.gov/idtheft to use a secure online version that you can print for your records.