Identity Theft Affidavit and Police Report Cover Letter - Alaska

IDENTITY THEFT AFFIDAVIT AND POLICE REPORT COVER LETTER — ALASKA

PART A: FTC IDENTITY THEFT REPORT INSTRUCTIONS

Step 1: File an FTC Identity Theft Report

The Federal Trade Commission (FTC) provides a centralized identity theft reporting system at IdentityTheft.gov. Filing an FTC Identity Theft Report is critical because it:

• Creates an official Identity Theft Report recognized under the Fair Credit Reporting Act (FCRA)
• Serves as the basis for requesting credit reporting agencies (CRAs) to block fraudulent information under 15 U.S.C. § 1681c-2
• Generates a personalized recovery plan with pre-filled letters and forms
• Satisfies documentation requirements for many creditors and financial institutions

Procedure:

1. Visit https://IdentityTheft.gov
2. Create an account (recommended) or proceed without one
3. Answer questions about the identity theft incident
4. Receive your Identity Theft Report and personalized recovery plan
5. Print and save the Identity Theft Report — you will need copies for creditors, CRAs, and law enforcement

Practice Note: The FTC Identity Theft Report has replaced the former FTC Identity Theft Affidavit (FTC Form 14039) for most purposes. However, some creditors and institutions may still request the older affidavit form. The comprehensive affidavit in Part B of this template satisfies both requirements.

Step 2: Contact the Three Major Credit Reporting Agencies

Step 3: Place Fraud Alerts

Initial Fraud Alert (1 Year):

• Contact ONE of the three CRAs; that agency must notify the other two
• Lasts 1 year (extended from 90 days by the Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018)
• Requires creditors to take reasonable steps to verify identity before opening new accounts

Extended Fraud Alert (7 Years):

• Available to confirmed identity theft victims who have filed an Identity Theft Report
• Lasts 7 years
• Requires creditors to contact the consumer directly using the phone number provided before opening new accounts
• Consumer is removed from pre-screened credit offer lists for 5 years

Step 4: Place Security Freezes

Under the Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018, security freezes are free nationwide. Under Alaska law (AS 45.48.100 et seq.), consumers may also request security freezes directly from CRAs.

Alaska-Specific Security Freeze Provisions (AS 45.48.100-210):

• A consumer may prohibit a CRA from releasing their credit report or credit score without express authorization
• CRA must place freeze within 5 business days of receiving request with proper identification
• To temporarily or permanently lift a freeze, the CRA must act within 3 business days of receiving the request
• Identity theft victims are exempt from the state fee (if any) for placing a freeze
• If a CRA releases information in violation of a security freeze, it must notify the consumer within 5 business days, identifying what was released and to whom
• Alaska law provides CRA exemptions for certain entities (child support agencies, law enforcement with court orders, existing creditors for account review)

PART B: IDENTITY THEFT AFFIDAVIT

SECTION 1: VICTIM INFORMATION

Full Legal Name: [________________________________]

Former/Maiden/Other Names Used: [________________________________]

Date of Birth: [__/__/____]

Social Security Number: [____] - [____] - [____]

Current Address:

Street: [________________________________]

City: [________________________________] State: [____] ZIP: [____]

How long at this address? [________________________________]

Previous Address (if at current address less than 2 years):

Street: [________________________________]

City: [________________________________] State: [____] ZIP: [____]

Home Phone: [________________________________]

Work Phone: [________________________________]

Cell Phone: [________________________________]

Email Address: [________________________________]

Driver's License Number: [________________________________] State: [____]

Alaska Identification Card Number (if applicable): [________________________________]

SECTION 2: FRAUDULENT ACCOUNT INFORMATION

Complete one entry for each fraudulent account. Attach additional pages if necessary.

Fraudulent Account #1

Fraudulent Account #2

Fraudulent Account #3

(Attach additional pages using the same format for additional fraudulent accounts.)

SECTION 3: HOW THE IDENTITY THEFT OCCURRED

How did you first discover the identity theft?

[________________________________]
[________________________________]
[________________________________]

When did the identity theft first occur (or your best estimate)? [__/__/____]

When did you first discover the identity theft? [__/__/____]

Do you know or suspect how the identity thief obtained your personal information?

☐ Lost or stolen wallet/purse
☐ Lost or stolen mail
☐ Data breach notification received (Company: [________________________________])
☐ Stolen from home, car, or office
☐ Someone I know had access to my information
☐ Phishing email or phone scam
☐ Online data compromise
☐ Medical or insurance records theft
☐ Tax-related identity theft
☐ Unknown
☐ Other: [________________________________]

SECTION 4: KNOWN OR SUSPECTED PERPETRATOR INFORMATION

Do you know or suspect who committed the identity theft?

☐ No — Skip to Section 5
☐ Yes — Complete below

Suspected Perpetrator's Name: [________________________________]

Relationship to Victim: [________________________________]

Last Known Address: [________________________________]

Phone Number: [________________________________]

Other Identifying Information: [________________________________]

Why do you suspect this person?

[________________________________]
[________________________________]

SECTION 5: TIMELINE OF EVENTS AND ACTIONS TAKEN

List all actions taken in response to the identity theft, in chronological order.

SECTION 6: ACTIONS ALREADY TAKEN

☐ Filed FTC Identity Theft Report at IdentityTheft.gov — Report Number: [________________________________]
☐ Filed police report — Agency: [________________________________] Report Number: [________________________________]
☐ Placed initial fraud alert (1-year) with: ☐ Equifax ☐ Experian ☐ TransUnion — Date: [__/__/____]
☐ Placed extended fraud alert (7-year) — Date: [__/__/____]
☐ Placed security freeze with: ☐ Equifax ☐ Experian ☐ TransUnion — Date: [__/__/____]
☐ Requested free credit reports from all three CRAs
☐ Contacted affected creditors/financial institutions
☐ Contacted debt collectors regarding fraudulent debts
☐ Notified Alaska Attorney General's Office
☐ Filed IRS Identity Theft Affidavit (Form 14039) — if tax-related
☐ Contacted Social Security Administration — if SSN compromised
☐ Contacted U.S. Postal Inspection Service — if mail theft involved
☐ Changed passwords and PINs on all accounts
☐ Other: [________________________________]

SECTION 7: DECLARATION UNDER PENALTY OF PERJURY

I, [________________________________], declare under penalty of perjury under the laws of the United States and the State of Alaska that the information provided in this affidavit is true and correct to the best of my knowledge. I understand that knowingly making false statements in this affidavit may subject me to criminal prosecution under 18 U.S.C. § 1001 (false statements to federal agencies) and AS 11.56.200 (unsworn falsification).

I did not authorize any person to use my personal identifying information to open or access any of the accounts or conduct any of the transactions listed in this affidavit. I am willing to cooperate fully with any law enforcement agency, creditor, or credit reporting agency investigating this identity theft.

Signature: ________________________________________

Printed Name: [________________________________]

Date: [__/__/____]

NOTARIZATION BLOCK

STATE OF ALASKA
[____] Judicial District

Before me, the undersigned Notary Public, on this [____] day of [________________________________], 20[____], personally appeared [________________________________], known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to the within instrument, and acknowledged to me that they executed the same in their authorized capacity, and that by their signature on the instrument, the person, or the entity upon behalf of which the person acted, executed the instrument.

WITNESS my hand and official seal.

Notary Public Signature: ________________________________________

Printed Name: [________________________________]

My Commission Expires: [__/__/____]

Notary Seal/Stamp:

[SEAL]

PART C: POLICE REPORT COVER LETTER

[__/__/____]

[________________________________]
[________________________________]
[________________________________]
[________________________________]

Re: Request to File Identity Theft Police Report

Dear Officer/Detective:

I am writing to request that your department accept and file an identity theft report pursuant to Alaska law and federal requirements. I am a victim of identity theft and need an official police report to exercise my rights under the Fair Credit Reporting Act (15 U.S.C. § 1681 et seq.) and Alaska's Personal Information Protection Act (AS 45.48).

Background

My personal identifying information has been used without my authorization to open fraudulent accounts, make unauthorized transactions, and/or commit other fraudulent acts as detailed in the attached Identity Theft Affidavit. The total known fraudulent activity amounts to approximately $[________________________________].

Why a Police Report Is Necessary

Federal law and Alaska law provide identity theft victims with important protections that require a police report:

1. FCRA Block Requests (15 U.S.C. § 1681c-2): Credit reporting agencies must block fraudulent information from a victim's credit report upon receipt of an identity theft report, which includes a police report and identity theft affidavit.

2. Extended Fraud Alerts (15 U.S.C. § 1681c-1): Victims with an identity theft report can request a 7-year extended fraud alert on their credit files.

3. Creditor Information Rights: With a police report, victims can demand that creditors provide copies of fraudulent account applications and transaction records.

4. Debt Collection Protection: Under the FDCPA and FCRA, a police report strengthens a victim's ability to halt collection of fraudulent debts.

Alaska Criminal Law Provisions

Identity theft is a criminal offense in Alaska under several statutes:

• AS 11.46.565 (Criminal Impersonation in the First Degree): A person commits criminal impersonation in the first degree if they assume a false identity and engage in conduct that could subject another person to criminal liability, or pretend to be a representative of a person or organization and do an act that could benefit or injure another person. This is a Class B felony.

• AS 11.46.180 (Theft by Deception): Using another person's identity to obtain property or services through deception constitutes theft, with the grade of offense depending on the value of the property or services obtained.

Jurisdiction

Under Alaska law, this report may be filed with:

• The law enforcement agency in the jurisdiction where the identity theft occurred
• The law enforcement agency in the jurisdiction where the victim resides
• The Alaska State Troopers if the identity theft crossed jurisdictional lines or occurred online

Information and Documents I Am Providing

☐ Completed Identity Theft Affidavit (attached)
☐ FTC Identity Theft Report (attached)
☐ Government-issued photo identification
☐ Proof of current address (utility bill, lease, or bank statement)
☐ Credit reports showing fraudulent accounts (highlighted)
☐ Collection notices for fraudulent debts
☐ Correspondence from creditors regarding fraudulent accounts
☐ Documentation of financial losses
☐ Other supporting evidence: [________________________________]

Request

I respectfully request that you:

1. Accept this identity theft report and assign a case number
2. Provide me with a copy of the filed police report
3. Investigate the identity theft to the extent possible
4. Refer the matter to appropriate investigative units if the crime crosses jurisdictions

Thank you for your assistance. I understand that identity theft investigations can be complex and am prepared to cooperate fully with any investigation.

Respectfully,

Signature: ________________________________________

Printed Name: [________________________________]

Address: [________________________________]

Phone: [________________________________]

Email: [________________________________]

PART D: ALASKA-SPECIFIC IDENTITY THEFT PROTECTIONS

Criminal Penalties (AS 11.46.565)

Criminal impersonation in the first degree is a Class B felony in Alaska, punishable by up to 10 years imprisonment. Additional charges may apply depending on the conduct:

Personal Information Protection Act (AS 45.48)

Alaska's Personal Information Protection Act provides the following protections:

Security Breach Notification (AS 45.48.010-090):

• Businesses and government agencies must notify Alaska residents of security breaches involving personal information
• Notification must be made "in the most expedient time possible and without unreasonable delay"
• Written notice must include: description of the incident, type of information involved, steps taken, contact information, and advice to remain vigilant

Security Freeze (AS 45.48.100-210):

• Consumers may place a free security freeze on their credit report
• CRA must place freeze within 5 business days of request
• CRA must lift freeze within 3 business days of request
• Violations by CRAs require consumer notification within 5 business days

Filing a Complaint with the Alaska Attorney General

Alaska Department of Law — Consumer Protection Unit
1031 W. 4th Avenue, Suite 200
Anchorage, AK 99501-1994
Phone: (907) 269-5200
Toll-Free: (888) 576-2529
Website: law.alaska.gov/department/civil/consumer.html

PART E: SUPPORTING DOCUMENTATION CHECKLIST

Gather and organize the following documents before submitting your affidavit:

Required Documents

☐ Completed Identity Theft Affidavit (Part B of this template)
☐ FTC Identity Theft Report from IdentityTheft.gov
☐ Police report with case number
☐ Government-issued photo identification (driver's license, passport, or state ID)
☐ Proof of current address (utility bill, lease agreement, or bank statement dated within 90 days)

Credit-Related Documents

☐ Credit reports from all three CRAs (Equifax, Experian, TransUnion) with fraudulent items highlighted
☐ Fraud alert confirmation letters
☐ Security freeze confirmation letters/PINs
☐ Any credit monitoring alerts related to the identity theft

Fraudulent Account Documents

☐ Statements or notices for fraudulent accounts
☐ Collection letters for fraudulent debts
☐ Correspondence with creditors regarding disputes
☐ Denial letters for credit applications you did not make

Financial Impact Documents

☐ Bank statements showing unauthorized transactions
☐ Records of out-of-pocket expenses related to the identity theft
☐ Records of lost wages or time spent resolving the identity theft
☐ Documentation of any denied credit, employment, or housing due to identity theft

Communication Records

☐ Log of all phone calls made (date, time, person spoken to, reference numbers)
☐ Copies of all letters sent (with certified mail receipts)
☐ Email correspondence with creditors, CRAs, and law enforcement
☐ Screenshots of online submissions or dispute filings

PART F: RECIPIENT LIST — WHO TO SEND THE AFFIDAVIT TO

Send copies of your completed affidavit, FTC Identity Theft Report, and police report to each of the following, as applicable. Use certified mail with return receipt requested for all mailings.

1. Credit Reporting Agencies (All Three)

2. Each Affected Creditor or Financial Institution

Send to the creditor's fraud/identity theft department (not the general customer service address). Include:

• Identity Theft Affidavit
• FTC Identity Theft Report
• Police report
• Request to close/block fraudulent account

3. Debt Collectors

If any fraudulent debts have been sent to collections, send the affidavit and supporting documents to each collector with a demand to cease collection of the fraudulent debt.

4. Alaska Attorney General — Consumer Protection Unit

File a complaint to create an official state record and assist with investigations.

5. Internal Revenue Service (If Tax-Related)

IRS Identity Protection Specialized Unit
Phone: 1-800-908-4490
Submit IRS Form 14039 (Identity Theft Affidavit) if fraudulent tax returns were filed.

6. Social Security Administration (If SSN Compromised)

Phone: 1-800-772-1213
Website: ssa.gov — Report fraud at oig.ssa.gov

SOURCES AND REFERENCES

• Federal Trade Commission — IdentityTheft.gov: https://www.identitytheft.gov
• Fair Credit Reporting Act, 15 U.S.C. § 1681 et seq.: https://www.law.cornell.edu/uscode/text/15/chapter-41/subchapter-III
• FCRA Block Provision, 15 U.S.C. § 1681c-2: https://www.law.cornell.edu/uscode/text/15/1681c-2
• FCRA Fraud Alerts, 15 U.S.C. § 1681c-1: https://www.law.cornell.edu/uscode/text/15/1681c-1
• Alaska Criminal Impersonation, AS 11.46.565: https://www.akleg.gov/basis/statutes.asp#11.46.565
• Alaska Personal Information Protection Act, AS 45.48: http://www.law.state.ak.us/department/civil/consumer/4548.html
• Alaska Department of Law — ID Theft & Privacy: https://law.alaska.gov/department/civil/Consumer/IDtheft.html
• Consumer Financial Protection Bureau: https://www.consumerfinance.gov
• Annual Free Credit Reports: https://www.annualcreditreport.com

This template is provided for informational purposes only and does not constitute legal advice. Identity theft cases involve complex intersections of federal and state law. Consult a qualified attorney licensed in Alaska for advice specific to your situation.