Letter Form 115-2
Letter Forms for When You Know the Imposter
There are three ITRC Letter Forms for “When You Know the Imposter.”
These Forms are suggestions only and should not take the place of forms or letters provided by your attorney, law enforcement, or creditors. Letters should be mailed certified, return receipt requested.
Please DO NOT send any letter forms or documentation to the ITRC as we cannot clear the fraud for you.
Letter Form 115-2:
To be written by the imposter accepting responsibility for accounts or charges.
Use a separate letter for each creditor you are contacting. Keep a copy of each for your records. We recommend that each form (one per fraudulent account) be notarized when the imposter signs it. The imposter should pay for that charge. Make enough copies for each account needed and a few extra for your files. Attach any documentation (e.g. police report) that will help the creditor to deal with this situation.
My name is (full legal name).
_________________________________________________
This is to notify you that:
____ I opened the following credit account(s) in the victim’s name.
____ I added charges onto an existing credit card account owned by the victim.
____ I took over a bank account or checking account owned by the victim.
____ I opened a bank account or checking account in the victim’s name.
Account Number of fraudulent account(s):
____________________________________
____________________________________
Date Opened for Each___________;___________
Approximate amount of charges to date:
___________
___________
___________
Social Security number used to open account: ____-___-_______
Legal authorization: (have imposter initial each)
___The victim did not authorize me to use his/her name or personal information to seek the money, credit, loans, goods or services described in this report.
___The victim did not have any knowledge of my actions described in this report.
___The victim did not receive any benefit, money, goods, or services as a result of the events described in this report.
___A police report has been filed about this situation. (___)Yes – attached ; (___) No
___ I wish to assume full financial responsibility for all charges made by me in the name of the victim and contact me exclusively to make arrangements for repayment of these charges. I also request that a written confirmation be sent to the victim showing:
- That all fraudulent charges have been removed from their records within your company.
- That the credit bureaus Experian, Equifax and TransUnion have been contacted to remove the fraudulent account/charges from their records.
Imposter Information:
My full legal name: __________________________________________
When the events described in this affidavit took place, my name was: ___________________________________
My Social Security number is _____-___-__________
My driver’s license number is: State and number
_________________________________
My current address is:
Street:___________________
City:_____________________
State:____________________
Zip Code:_________________
I have lived at this address since ________(month/year)
When the events described in this affidavit took place, my address was:
Street:___________________
City:_____________________
State:_________________
Zip Code:____________
Phone numbers:
Daytime: (____)___________
Evening: (_ __)___________
Cell: (____)_________
My email address is ____________________
Victim Information:
Victim’s full legal name: My full legal name is:_____________________________
When the events described in this affidavit took place, I was known as: _________________________________(If different from above)
My birth date is (day/month/year): ____________________
My Social Security number is ___-__-____
My driver’s license or identification card number is:
State________ #________________
My current address is:
Street:___________________
City:_____________________
State:_________________
Zip Code:____________
I have lived at this address since ________(month/year)
When the events described in this affidavit took place, my address was:
Street:___________________
City:_____________________
State:_________________
Zip Code:____________
I lived at that address from ______ until ______(month/year)
Phone numbers:
Daytime: (____)___________
Evening: (_ __)___________
Cell: (____)_________
My e-mail address is _________________________
Victim’s Social Security number: ____-___-_______
_______________________________
Signature of victim
________________
Date of Signing
I declare under penalty of perjury that this declaration is true and correct to the best of my knowledge.
_____________________________
Signature of imposter
_________________
Date of Signing
Knowingly submitting false information on this affidavit could subject you to criminal prosecution for perjury.
(Have this form notarized; the imposter should pay this cost.)
Copyright February 2007, Identity Theft Resource Center®, all rights reserved.
Written by Linda Foley, assisted by Mari Frank, Esq.
P.O. Box 26833, San Diego CA 92196
Email: itrc@idtheftcenter.org
Resource material of the Identity Theft Resource Center: http://www.idtheftcenter.org/
The information in this publication is not to be considered legal or psychological advice. This information is a resource for you and has been helpful for other victims in similar situations. If you have any legal questions or concerns, you should consult with a consumer law attorney.
Fact Sheet 115 When you Personally Know the Identity Theif