Identity Theft Affidavit and Police Report Cover Letter - California

IDENTITY THEFT AFFIDAVIT AND POLICE REPORT COVER LETTER — CALIFORNIA

California has the strongest state identity theft protections in the nation. California victims have rights under the California Identity Theft Act (Civ. Code § 1798.92 et seq.), including the right to compel law enforcement to take a report (Penal Code § 530.6), entry into the DOJ identity theft database (Penal Code § 530.7), and access to fraudulent account records (Penal Code § 530.8).

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 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, the comprehensive affidavit in Part B of this template provides additional detail useful for California-specific rights enforcement.

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 under federal law
• 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 before opening new accounts
• Consumer is removed from pre-screened credit offer lists for 5 years

California-Enhanced Fraud Alert:
Under Cal. Civ. Code § 1785.11.1, California identity theft victims are entitled to:

• A fraud alert placed on their credit file upon request
• Automatic notification of any attempt to establish new credit in the victim's name
• The right to request that the CRA not release the credit report without prior express authorization

Step 4: Place Security Freezes

Under the Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018, security freezes are free nationwide. California was among the first states to enact security freeze legislation.

California Credit Freeze Provisions (Civ. Code § 1785.11.2 et seq.):

• CRA must place freeze within 3 business days of receiving request
• CRA must temporarily lift freeze within 3 business days of receiving request with proper authorization
• California residents may also place freezes on behalf of minor children under 16 (Civ. Code § 1785.11.6)
• California law provides enhanced protections for protected consumers (incapacitated adults, those with court-appointed guardians)

Step 5: Request Free Credit Reports

Under California Law:

• Identity theft victims are entitled to up to 12 free credit reports per year from each CRA (Civ. Code § 1785.15.3)
• This is in addition to the one free annual report available to all consumers at AnnualCreditReport.com
• Request directly from each CRA, citing your California identity theft victim status

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: CA 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: [________________________________]

California Driver's License Number: [________________________________]

California ID 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
☐ Employment-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

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
☐ Requested entry into CA DOJ Identity Theft Registry (Penal Code § 530.7)
☐ Requested fraudulent account records under Penal Code § 530.8
☐ Filed complaint with California Attorney General
☐ 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 California 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 Cal. Penal Code § 118 (perjury).

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 CALIFORNIA
COUNTY OF [________________________________]

A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document.

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

I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct.

WITNESS my hand and official seal.

Notary Public Signature: ________________________________________

Printed Name: [________________________________]

My Commission Expires: [__/__/____]

Commission Number: [________________________________]

Notary Seal/Stamp:

[SEAL]

Note: California Civil Code § 1189 requires this specific notarial certificate format. The advisory language in the first paragraph is required by Cal. Civ. Code § 1189(a)(2).

PART C: POLICE REPORT COVER LETTER

[__/__/____]

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

Re: Request to File Identity Theft Police Report Pursuant to California Penal Code § 530.6

Dear Officer/Detective:

I am writing to request that your department accept and file an identity theft report as required by California Penal Code § 530.6. Under this statute, when a person reasonably suspects that they are a victim of identity theft, they may initiate a law enforcement investigation by contacting the local law enforcement agency, which shall take a police report of the matter and begin an investigation.

Mandatory Duty to Accept Report

California Penal Code § 530.6(a) creates a mandatory duty for law enforcement agencies to accept identity theft reports. The statute provides:

"A person who has learned or reasonably suspects that his or her personal identifying information has been unlawfully used by another...may initiate a law enforcement investigation by contacting the local law enforcement agency that has jurisdiction over his or her actual residence...which shall take a police report of the matter, and provide the complainant with a copy of that report..."

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 $[________________________________].

California Criminal Law Provisions

Identity theft is a serious criminal offense in California:

Request for Investigation and Report

I respectfully request that you:

1. Accept this identity theft report and assign a case number as required by Penal Code § 530.6(a)
2. Provide me with a copy of the filed police report
3. Investigate the identity theft to the extent possible
4. If the crime occurred outside your jurisdiction, refer the matter to the appropriate agency per Penal Code § 530.6(a)

Information and Documents I Am Providing

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

Respectfully,

Signature: ________________________________________

Printed Name: [________________________________]

Address: [________________________________]

Phone: [________________________________]

Email: [________________________________]

PART D: CALIFORNIA-SPECIFIC IDENTITY THEFT PROTECTIONS

California Identity Theft Act (CITA) — Civ. Code § 1798.92 et seq.

The California Identity Theft Act provides the most robust state-level protections for identity theft victims in the nation:

Creditor Investigation Requirement (§ 1798.93):

• When a victim sends written notification (including a police report and FTC report) to a creditor or debt collector, the entity must cease reporting the fraudulent account to CRAs and cease collection activity within 30 days unless it can demonstrate the debt is not fraudulent
• The creditor must provide the victim with all relevant records within 30 days

Civil Penalties (§ 1798.93):

• A creditor that willfully fails to comply may be liable for civil penalties of up to $30,000 per violation
• Victims may also recover actual damages, attorney fees, and costs

Debt Collector Obligations (§ 1798.93(c)):

• Debt collectors must stop collecting on a debt upon receipt of a written certification from the consumer that the debt resulted from identity theft, accompanied by a police report and FTC report

Penal Code Victim Rights

Right to File a Report (§ 530.6):

• Law enforcement must take a police report from any person who reasonably suspects identity theft
• If the crime occurred in another jurisdiction, the local agency may refer the matter but must still take the initial report

Judicial Determination of Factual Innocence (§ 530.6(a)):

• A victim may petition the court for an expedited judicial determination of factual innocence
• If granted, the court will issue an order that may be used to compel agencies to correct records

DOJ Identity Theft Database (§ 530.7):

• California maintains a statewide database of identity theft victims through the Department of Justice
• Victims may request entry into the database, which provides verification for law enforcement and creditors
• Entry into the database helps prevent wrongful arrest if the identity thief committed crimes in the victim's name

Access to Fraudulent Account Records (§ 530.8):

• Victims (or their law enforcement representative) are entitled to receive:
• Copies of the fraudulent account application
• Transaction records associated with the fraudulent account
• Any other records related to the identity theft
• Entities that must comply include banks, credit unions, savings associations, utilities, mobile radio services, and mail forwarding services
• Records must be provided within 30 days of request

California Credit Reporting Protections

Automatic Security Alert (Civ. Code § 1785.11.1):

• Identity theft victims may place a security alert on their credit file
• CRAs must contact the victim before releasing the credit report

Free Credit Reports (Civ. Code § 1785.15.3):

• Identity theft victims are entitled to up to 12 free credit reports per year from each CRA
• This is in addition to the annual free report available to all consumers

Minor Child Protections (Civ. Code § 1785.11.6):

• Parents and legal guardians may place security freezes on behalf of minor children under 16

California Data Breach Notification (Civ. Code § 1798.29, § 1798.82)

• Businesses must notify California residents of data breaches "in the most expedient time possible and without unreasonable delay"
• Notification must be in plain language and include specific information about the breach
• If more than 500 California residents are affected, the entity must also notify the California Attorney General
• Breaches involving Social Security numbers require the entity to offer free identity theft prevention and mitigation services for at least 12 months

Filing Complaints

California Attorney General — Bureau of Identity Theft
P.O. Box 944255
Sacramento, CA 94244-2550
Phone: (800) 952-5225
Website: oag.ca.gov/idtheft

California Department of Justice — Identity Theft Registry
Phone: (888) 880-0240
Website: oag.ca.gov/idtheft/registry

PART E: SUPPORTING DOCUMENTATION CHECKLIST

Required Documents

☐ Completed Identity Theft Affidavit (Part B of this template)
☐ FTC Identity Theft Report from IdentityTheft.gov
☐ Police report with case number (required by Penal Code § 530.6)
☐ Government-issued photo identification
☐ Proof of current California address

California-Specific Documents

☐ CA DOJ Identity Theft Registry confirmation (if applicable)
☐ Judicial determination of factual innocence (Penal Code § 530.6, if obtained)
☐ Records obtained from creditors under Penal Code § 530.8

Credit-Related Documents

☐ Credit reports from all three CRAs with fraudulent items highlighted
☐ Fraud alert confirmation letters
☐ Security freeze confirmation letters/PINs
☐ 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
☐ Records of lost wages or time spent resolving the identity theft
☐ Documentation of any denied credit, employment, or housing

Communication Records

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

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

Use certified mail with return receipt requested for all mailings.

1. Credit Reporting Agencies (All Three)

2. Each Affected Creditor or Financial Institution

Include Identity Theft Affidavit, FTC Report, police report, and demand under CITA (Civ. Code § 1798.93) to cease collection and reporting within 30 days.

3. Debt Collectors

Include demand to cease collection under Civ. Code § 1798.93(c) with written certification, police report, and FTC report.

4. California Attorney General — Bureau of Identity Theft

5. California DOJ Identity Theft Registry

Request entry for ongoing protection against wrongful arrest and to assist in future identity verification.

6. Internal Revenue Service (If Tax-Related)

IRS Identity Protection Specialized Unit: 1-800-908-4490

7. Social Security Administration (If SSN Compromised)

Phone: 1-800-772-1213 | Report fraud: 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
• Cal. Penal Code § 530.5 (Identity Theft): https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=PEN&sectionNum=530.5
• Cal. Civ. Code § 1798.92-1798.98 (California Identity Theft Act): https://law.justia.com/codes/california/code-civ/division-3/part-4/title-1-81-3/
• California Attorney General — Identity Theft: https://oag.ca.gov/idtheft
• California Identity Theft Victim Rights: https://oag.ca.gov/sites/all/files/agweb/pdfs/idtheft/know_your_rights_id_theft.pdf
• 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. California identity theft law provides extensive protections; consult a qualified attorney licensed in California to ensure you take full advantage of all available remedies.