Iowa Identity Theft Affidavit and Police Report Cover Letter

IOWA IDENTITY THEFT AFFIDAVIT AND POLICE REPORT COVER PACKET

TABLE OF CONTENTS

1. Police Report Cover Letter
2. Identity Theft Affidavit
3. Schedule A — Fraudulent Accounts and Transactions
4. Schedule B — Documents Provided
5. FCRA § 605B Block Request — Cover Letter to Credit Reporting Agencies
6. Iowa Practice Notes
7. Sources and References

1. POLICE REPORT COVER LETTER

[YOUR FULL LEGAL NAME]

[STREET ADDRESS]

[CITY], Iowa [ZIP]**

[PHONE] | [EMAIL]

Date: [DATE]

[POLICE DEPARTMENT NAME — e.g., Des Moines Police Department / [COUNTY] County Sheriff's Office]

Records / Identity Theft Unit

[STREET ADDRESS]

[CITY], Iowa [ZIP]**

RE: Request to File Identity Theft Police Report — Iowa Code § 715A.8

Dear Records Unit:

I am the victim of identity theft as defined in Iowa Code § 715A.8. Pursuant to that statute and in accordance with the Federal Trade Commission's recommended procedures, I am requesting that your department take a written report of the identity theft and provide me with a copy of the report (or a report number) so that I may use it to dispute fraudulent accounts with credit reporting agencies under 15 U.S.C. § 1681c-2 (FCRA § 605B) and pursue civil remedies under Iowa Code § 714.16B.

I have enclosed a notarized Identity Theft Affidavit, supporting documents, and a list of fraudulent accounts and transactions. I request that the report be assigned a file number and that I be provided a stamped, file-marked copy.

I understand that under Iowa law, identity theft is a class D felony where the value involved exceeds $1,000, and an aggravated misdemeanor otherwise. I am willing to cooperate fully, including signing a complaint, providing additional documents, and assisting with any investigation.

Date the identity theft was discovered: [DATE]

Date(s) of fraudulent activity (if known): [DATE RANGE]

Suspects (if known): [NAME(S) / "UNKNOWN"]

Total estimated loss: $[AMOUNT]

Thank you for your assistance.

Sincerely,

[________________________________]

[YOUR PRINTED NAME]

Enclosures:
☐ Notarized Identity Theft Affidavit
☐ Schedule A — Fraudulent Accounts and Transactions
☐ Schedule B — Documents Provided
☐ Government-issued photo identification (copy)
☐ Proof of address (copy)
☐ FTC IdentityTheft.gov Report (copy), if available

2. IDENTITY THEFT AFFIDAVIT

STATE OF IOWA

COUNTY OF [COUNTY]

I, [YOUR FULL LEGAL NAME], being first duly sworn upon oath, state as follows:

A. Affiant Identification

1. My full legal name is [FULL LEGAL NAME], and I currently reside at [STREET ADDRESS], [CITY], Iowa [ZIP].

2. My date of birth is [__/__/____]. The last four digits of my Social Security number are [XXXX].

3. I am over the age of 18 and competent to give this affidavit.

B. Statement of Identity Theft

4. I am the victim of identity theft within the meaning of Iowa Code § 715A.8 and 18 U.S.C. § 1028. I did not authorize, consent to, or benefit from any of the accounts, transactions, or applications described in Schedule A attached hereto.

5. I first discovered the identity theft on or about [DATE] when [describe — e.g., I received a collection letter for an account I never opened; I checked my credit report and saw unfamiliar accounts; I received a data breach notice from [ENTITY]; my bank notified me of suspicious activity].

6. The total estimated loss to me as a result of the identity theft is approximately $[AMOUNT], including out-of-pocket payments, charges to fraudulent accounts, time off work, fees paid to credit-monitoring services, and costs of repairing my credit history.

C. Source of Compromise (if known)

7. To the best of my knowledge and belief, my personal information was compromised through ☐ a data breach at [ENTITY] for which I received notice under Iowa Code Chapter 715C on or about [DATE]; ☐ theft of mail; ☐ theft of physical documents (wallet, purse, briefcase); ☐ phishing email or text; ☐ unauthorized access to an online account; ☐ a known suspect named [NAME]; ☐ other: [DESCRIBE]; ☐ unknown.

D. Denial of Authorization

8. I did not authorize anyone to use my name, Social Security number, date of birth, address, or any other identifying information to open or maintain any of the accounts listed in Schedule A.

9. I did not receive any goods, services, money, or other benefit from any account listed in Schedule A.

10. I am not pursuing this affidavit for the purpose of avoiding a debt that I lawfully incurred or that resulted from any dispute with a creditor.

E. Steps Already Taken

11. I have taken or am taking the following steps:

☐ Placed an initial fraud alert on my credit file pursuant to 15 U.S.C. § 1681c-1 with [Equifax / Experian / TransUnion] on [DATE];

☐ Filed a report with the FTC at IdentityTheft.gov on [DATE], Report No. [NUMBER];

☐ Filed (or am filing) a police report with [AGENCY] in [CITY], Iowa;

☐ Notified each affected creditor in writing;

☐ Requested a security freeze on my credit files pursuant to 15 U.S.C. § 1681c-1(i);

☐ Closed all known compromised accounts and opened new accounts with new account numbers, PINs, and passwords;

☐ Notified the Social Security Administration and IRS, where applicable;

☐ Filed a complaint with the Iowa Attorney General's Consumer Protection Division.

F. Requests for Action

12. Pursuant to 15 U.S.C. § 1681c-2 (FCRA § 605B), I request that each consumer reporting agency BLOCK the reporting of all information identified in Schedule A within four business days of its receipt of this affidavit.

13. Pursuant to 15 U.S.C. § 1681g(e), I request that each business associated with a fraudulent account in Schedule A provide me with copies of all application and transaction records relating to that account.

14. Pursuant to 15 U.S.C. § 1681m(f), no debt that I dispute as resulting from identity theft may be sold, transferred for consideration, or placed for collection.

15. I reserve all rights and remedies under Iowa Code § 714.16B for civil damages of $5,000 or three times actual damages, whichever is greater, plus costs of repairing my credit, attorney fees, court costs, and punitive damages, against any person who fraudulently used my identification information.

G. Verification

16. I have read this affidavit, including Schedules A and B. The statements herein are true and correct to the best of my knowledge, information, and belief, and I understand that any false statement may be punishable under Iowa Code § 720.2 (perjury) and other applicable law.

[________________________________]

[YOUR PRINTED NAME], Affiant

Date: [DATE]

Notarial Certificate

STATE OF IOWA

COUNTY OF [COUNTY]

Subscribed and sworn to (or affirmed) before me on this [____] day of [_______________], 20[____], by [YOUR PRINTED NAME], who is personally known to me or who produced [type of ID] as identification.

[________________________________]

Notary Public in and for the State of Iowa

(Printed Name): [_______________]

(My Commission Expires): [_______________]

(SEAL)

3. SCHEDULE A — FRAUDULENT ACCOUNTS AND TRANSACTIONS

I, [YOUR PRINTED NAME], certify under oath that I did not authorize, open, use, or benefit from any of the accounts or transactions listed above.

[________________________________]

[YOUR PRINTED NAME]

4. SCHEDULE B — DOCUMENTS PROVIDED

☐ Government-issued photo identification (driver's license, passport, or state ID)

☐ Proof of current address (utility bill, lease, bank statement)

☐ Copy of police report or police report number assigned

☐ Copy of FTC IdentityTheft.gov report

☐ Credit reports from Equifax, Experian, and TransUnion with disputed items marked

☐ Copies of fraudulent account statements, applications, or correspondence

☐ Iowa Code Chapter 715C breach notification letter (if applicable)

☐ Other: [________________________________]

5. FCRA § 605B BLOCK REQUEST — COVER LETTER TO CREDIT REPORTING AGENCIES

[YOUR FULL LEGAL NAME]

[STREET ADDRESS]

[CITY], Iowa [ZIP]**

[PHONE] | [EMAIL]

Date: [DATE]

[CRA NAME — Equifax Information Services LLC / Experian / TransUnion LLC]

P.O. Box [ADDRESS]

[CITY, STATE ZIP]

SENT VIA U.S. CERTIFIED MAIL — RETURN RECEIPT REQUESTED

Tracking No.: [________________________________]

RE: Request for Identity Theft Block under FCRA § 605B, 15 U.S.C. § 1681c-2

Dear Consumer Disputes Department:

I am a victim of identity theft. Pursuant to the Fair Credit Reporting Act, 15 U.S.C. § 1681c-2 (FCRA § 605B), I request that you block the reporting of all information described in the enclosed Schedule A from my consumer file within four (4) business days of your receipt of this letter and the appended documentation.

Enclosed are:

1. My notarized Identity Theft Affidavit;
2. My Iowa police report (Report No. [NUMBER], [AGENCY]) [and/or FTC IdentityTheft.gov report];
3. Government-issued photo identification (copy);
4. Proof of address (copy);
5. Schedule A identifying the fraudulent items by tradeline and account number.

I further request that you place an extended fraud alert in my file pursuant to 15 U.S.C. § 1681c-1(b) for a period of seven (7) years, and notify all furnishers and any users that requested my consumer report in the past two years (one year for employment) of the block.

If you decline to block any item, please notify me in writing of the specific reason within five (5) business days, as required by 15 U.S.C. § 1681c-2(b).

Thank you for your prompt attention.

Sincerely,

[________________________________]

[YOUR PRINTED NAME]

Enclosures as listed.

6. IOWA PRACTICE NOTES

• Iowa civil cause of action. Iowa Code § 714.16B allows a victim to recover the GREATER of $5,000 OR three times actual damages, plus costs of repairing credit, attorney fees, court costs, and punitive damages. Combine with FCRA claims against any furnisher or CRA that fails to comply with § 605B.
• Iowa Code § 715A.8. Identity theft is a class D felony where the value involved exceeds $1,000, otherwise an aggravated misdemeanor. A § 715A.8 violation is also an "unlawful practice" under Iowa Code § 714.16, opening AG enforcement.
• § 605B four-business-day block. A CRA must block within four business days of receiving (1) appropriate proof of identity, (2) a copy of an identity theft report, (3) the consumer's identification of the information, and (4) a statement that the information is not the result of any transaction by the consumer. 15 U.S.C. § 1681c-2(a).
• Identity theft report. FCRA § 603(q)(4) defines "identity theft report" as a report (a) alleging an identity theft; (b) filed by a consumer with an appropriate federal, state, or local law enforcement agency, "the filing of which subjects the person filing the report to criminal penalties relating to the filing of false information." An Iowa police report and an FTC IdentityTheft.gov report each satisfy the definition.
• Iowa Code Chapter 715C overlay. If the theft resulted from a notified data breach, identify the breaching entity and the date of notice. Breach notice within 5 business days to the AG is required for breaches affecting 500+ Iowa residents (Iowa Code § 715C.2(8)). Remedies under § 715C are AG-enforced; consumer remedies flow through Chapter 714 and 714H.
• Statute of limitations. Iowa Code § 614.1 generally provides two years for personal injury and five years for unwritten contract; the § 714.16B civil cause of action is silent on its own limitations period — the catch-all 5-year period under § 614.1(4) typically governs. Confirm with counsel.
• Address confidentiality. Iowa's Safe at Home program (Iowa Code Ch. 9E) may shield victims of certain crimes; consider eligibility.
• Iowa AG resources. The Iowa AG Consumer Protection Division provides identity-theft assistance and accepts complaints; see iowaattorneygeneral.gov.

7. SOURCES AND REFERENCES

• 15 U.S.C. § 1681c-2 (FCRA § 605B Block) — https://www.law.cornell.edu/uscode/text/15/1681c-2
• 15 U.S.C. § 1681c-1 (FCRA Fraud Alerts) — https://www.law.cornell.edu/uscode/text/15/1681c-1
• 15 U.S.C. § 1681g(e) (Records of fraudulent transactions) — https://www.law.cornell.edu/uscode/text/15/1681g
• 15 U.S.C. § 1681m(f) (Sale of identity-theft debts prohibited) — https://www.law.cornell.edu/uscode/text/15/1681m
• Iowa Code § 715A.8 (Identity theft) — https://www.legis.iowa.gov/docs/code/715A.8.pdf
• Iowa Code § 714.16B (Identity theft civil cause of action) — https://www.legis.iowa.gov/docs/code/714.16b.pdf
• Iowa Code Chapter 715C (Personal Information Security Breach Protection) — https://www.legis.iowa.gov/docs/code/715c.pdf
• Iowa AG Security Breach Notifications — https://www.iowaattorneygeneral.gov/for-consumers/security-breach-notifications
• FTC IdentityTheft.gov — https://www.identitytheft.gov/
• Iowa People's Law Library — Identity Theft — https://www.peopleslawiowa.org/index.php/research-topics/consumer-law/protecting-your-identity/identity-theft
• Iowa Identity Theft Victim Assistance Coalition — https://www.justice.gov/usao-ndia/page/file/1201431/download

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Iowa must review and customize this document before use. Laws, citations, and court rules change frequently; verify all authorities before use.