Identity Theft Affidavit and Police Report Cover - Montana

IDENTITY THEFT AFFIDAVIT AND LAW-ENFORCEMENT REPORT COVER — MONTANA

TABLE OF CONTENTS

1. Cover Letter to Law Enforcement
2. Victim Identification
3. Statement of Identity Theft (Sworn Affidavit)
4. Fraudulent Accounts and Transactions
5. Suspect Information (if known)
6. Documents Attached / Provided
7. Requests to Law Enforcement
8. FCRA Blocking and Fraud Alert Requests
9. Notification to Furnishers and Creditors
10. Security Freeze Notice — Montana
11. Verification and Notarization
12. Distribution List
13. Practice Notes
14. Sources and References

1. COVER LETTER TO LAW ENFORCEMENT

[VICTIM NAME]

[STREET ADDRESS]

[CITY, MT ZIP]

Telephone: [NUMBER]

Email: [EMAIL]

Date: [__/__/____]

[NAME OF MONTANA LAW ENFORCEMENT AGENCY]

Attn: Records / Identity Theft Unit

[STREET ADDRESS]

[CITY, MT ZIP]

RE: Request for Identity Theft Report under Mont. Code Ann. § 46-24-218

To Whom It May Concern:

I am the victim of identity theft as defined by Mont. Code Ann. § 45-6-332. Pursuant to Mont. Code Ann. § 46-24-218, I respectfully request that your agency take this report and issue me a written identity theft report. I understand that under § 46-24-218(2) the agency in the jurisdiction where I reside cannot refuse to take this report on the basis that the underlying conduct occurred outside the agency's jurisdiction.

I am submitting the attached sworn Identity Theft Affidavit, FTC Identity Theft Report (IdentityTheft.gov submission), and supporting documentation. I will sign any additional forms required by your agency.

Sincerely,

[________________________________]

[VICTIM NAME — printed]

2. VICTIM IDENTIFICATION

3. STATEMENT OF IDENTITY THEFT (SWORN AFFIDAVIT)

I, [VICTIM NAME], being first duly sworn, state as follows under penalty of perjury under the laws of the State of Montana and the United States:

3.1. I am the victim of identity theft as defined by 18 U.S.C. § 1028(a)(7), 15 U.S.C. § 1681a(q)(3), and Mont. Code Ann. § 45-6-332.

3.2. On or about [__/__/____] I first discovered that one or more unknown person(s) had obtained or used my personal identifying information without my consent. I discovered the theft by [describe — e.g., reviewing a credit report, receiving a collection notice, being denied credit, learning of a tax-refund flag from the IRS].

3.3. I have not authorized any person to open the account(s) or conduct the transaction(s) listed in Section 4.

3.4. I have not personally benefited from any of the fraudulent account(s) or transaction(s) and did not give any other person permission to use my identifying information for any unlawful purpose.

3.5. I am willing to assist in the prosecution of any person committing this fraud, and ☐ I am / ☐ I am not willing to provide testimony in court if necessary.

3.6. I have read this Affidavit, all attachments, and the documents listed in Section 6, and the contents are true and correct to the best of my knowledge and belief.

4. FRAUDULENT ACCOUNTS AND TRANSACTIONS

Total claimed loss to date: $[AMOUNT]

5. SUSPECT INFORMATION (IF KNOWN)

6. DOCUMENTS ATTACHED / PROVIDED

The following documents are attached or have been provided to law enforcement and/or the recipients listed in Section 12:

• ☐ Government-issued photo identification of victim;
• ☐ Proof of residential address (utility bill, lease, bank statement);
• ☐ FTC Identity Theft Report (IdentityTheft.gov), Report No. [___], dated [__/__/____];
• ☐ Copies of all collection notices, billing statements, and demand letters received concerning the fraudulent accounts;
• ☐ Copies of consumer reports from Equifax, Experian, and TransUnion with fraudulent items circled;
• ☐ Any data-breach notification(s) received from a furnisher under Mont. Code Ann. § 30-14-1704;
• ☐ Photographs of any physical evidence (recovered mail, ATM/store surveillance still images, etc.);
• ☐ List of locations where personal documents may have been compromised;
• ☐ Other: [___].

7. REQUESTS TO LAW ENFORCEMENT

I respectfully request that your agency:

7.1. Prepare and provide me with a written identity theft report as required by Mont. Code Ann. § 46-24-218, including a report number and the name and contact information of the assigned officer;

7.2. Investigate the conduct described above as a potential violation of Mont. Code Ann. § 45-6-332 (theft of identity);

7.3. Coordinate with any other Montana or federal law enforcement agency with concurrent jurisdiction (FBI, U.S. Postal Inspection Service, U.S. Secret Service, Internal Revenue Service Criminal Investigation Division), as appropriate; and

7.4. Provide me with a copy of the report at the address shown above.

8. FCRA BLOCKING AND FRAUD ALERT REQUESTS

The combination of the attached police report and the FTC Identity Theft Report constitutes an "Identity Theft Report" within the meaning of 15 U.S.C. § 1681a(q)(4) and 16 C.F.R. § 603.3. I demand that each consumer reporting agency receiving this packet:

• ☐ Block all information appearing on my consumer file that resulted from the identity theft listed in Section 4, pursuant to 15 U.S.C. § 1681c-2;
• ☐ Place an extended fraud alert on my file under 15 U.S.C. § 1681c-1(b) for a period of seven (7) years;
• ☐ Provide me, at no cost, two free consumer reports during the 12 months following the alert under 15 U.S.C. § 1681j(a) / (b);
• ☐ Provide me with disclosure of all records relating to the fraudulent transactions under 15 U.S.C. § 1681g(e); and
• ☐ Notify each furnisher of the blocked information of the identity theft under 15 U.S.C. § 1681c-2(b).

9. NOTIFICATION TO FURNISHERS AND CREDITORS

To each creditor or furnisher receiving this packet:

You are notified, pursuant to 15 U.S.C. § 1681s-2(a)(6) and 16 C.F.R. § 660.4 (Furnisher Rule), that the account(s) or transaction(s) referenced in Section 4 are the result of identity theft. You are required to:

• ☐ Cease reporting the disputed information to any consumer reporting agency;
• ☐ Investigate and respond to this notice in accordance with 15 U.S.C. § 1681s-2(a)(8);
• ☐ Provide me, upon written request, with copies of any application, contract, or transaction records relating to the fraudulent account under 15 U.S.C. § 1681g(e);
• ☐ Cease all collection activity on the disputed account; and
• ☐ Refrain from selling, transferring, or placing the alleged debt for collection under 15 U.S.C. § 1681m(f).

10. SECURITY FREEZE NOTICE — MONTANA

Pursuant to Mont. Code Ann. § 30-14-1722 (security freeze on consumer credit reports), I am invoking my right as a Montana consumer to place a security freeze on my consumer file. A Montana identity theft victim who provides a valid investigative or police report is entitled to place, lift, or remove a security freeze without charge.

I will separately submit a security freeze request to each of:

11. VERIFICATION AND NOTARIZATION

I declare under penalty of perjury under the laws of the State of Montana and the United States of America that the foregoing is true and correct.

Executed on [__/__/____] at [CITY], Montana.

[________________________________]

[VICTIM NAME — printed]

STATE OF MONTANA

COUNTY OF [COUNTY]

Subscribed and sworn to (or affirmed) before me on [__/__/____] by [VICTIM NAME], who is personally known to me or who produced [ID type and number] as identification.

[________________________________]

Notary Public for the State of Montana

(My Commission Expires: [__/__/____])

12. DISTRIBUTION LIST

13. PRACTICE NOTES

• Mandatory Montana police report. Mont. Code Ann. § 46-24-218 expressly requires a Montana law enforcement agency in the victim's county of residence to take an identity theft report; the agency cannot refuse based on jurisdictional limits because identity theft is deemed to occur where the victim resides.
• Identity Theft Report = FTC report + police report. Under 16 C.F.R. § 603.3, an FCRA "Identity Theft Report" requires (i) a report filed with a federal, state, or local law enforcement agency that subjects the filer to penalties for false statements and (ii) sufficient detail. The FTC's IdentityTheft.gov submission is a recognized component but should be paired with the local police report for full FCRA blocking rights.
• FCRA blocking. 15 U.S.C. § 1681c-2 obligates a CRA to block disputed identity-theft information within four business days of receipt of an Identity Theft Report; the block is permanent unless the consumer obtained the information by fraud, materially misrepresented the facts, or the information is subsequently confirmed through reasonable verification.
• Furnisher duties. 15 U.S.C. § 1681s-2(a)(6) and the Furnisher Rule (16 C.F.R. Part 660) require furnishers to cease reporting and investigate upon receipt of a sufficient identity-theft notice supported by an Identity Theft Report.
• Security freezes (Montana). Mont. Code Ann. § 30-14-1722 provides Montana consumers the right to place a free security freeze. Federal law (Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018) also makes nationwide security freezes free.
• Data breach connection. If the theft followed a data breach notice received under Mont. Code Ann. § 30-14-1704, retain the breach notice; the breach notice is admissible evidence of how the personal information was obtained and may support a separate civil action against the breached entity.
• Criminal restitution. Upon conviction under MCA § 45-6-332, the court may order restitution including attorney fees and costs of clearing the victim's credit history (§ 45-6-332(4)).
• Statute of limitations. The criminal limitations period for theft of identity in Montana is generally five (5) years for felony grades (MCA § 45-1-205); civil limitations vary by theory (FCRA — two years from discovery, 15 U.S.C. § 1681p; MCPA — generally two years under MCA § 27-2-211).

14. SOURCES AND REFERENCES

• Mont. Code Ann. § 45-6-332 (Theft of identity) — https://law.justia.com/codes/montana/title-45/chapter-6/part-3/section-45-6-332/
• Mont. Code Ann. § 46-24-218 (Identity theft report — process — investigation) — https://mca.legmt.gov/bills/mca/title_0460/chapter_0240/part_0020/section_0180/0460-0240-0020-0180.html
• Mont. Code Ann. § 30-14-1704 (Computer security breach) — https://mca.legmt.gov/bills/mca/title_0300/chapter_0140/part_0170/section_0040/0300-0140-0170-0040.html
• Mont. Code Ann. § 30-14-1722 (Security freeze)
• Montana Department of Justice — Reporting Requirements for Data Breaches — https://dojmt.gov/office-of-consumer-protection/reporting-requirements-for-data-breaches/
• 15 U.S.C. § 1681c-2 (FCRA — block of information from identity theft) — https://www.law.cornell.edu/uscode/text/15/1681c-2
• 15 U.S.C. § 1681s-2 (FCRA — duties of furnishers)
• 16 C.F.R. Part 603 (FTC Identity Theft Rule)
• FTC Identity Theft Resources — https://www.identitytheft.gov/
• IRS Identity Theft Affidavit (Form 14039) — https://www.irs.gov/identity-theft-fraud-scams
• Montana Office of Consumer Protection — https://dojmt.gov/consumer/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Montana should review and customize this document where significant dollar exposure or pending civil or criminal proceedings exist. Laws, citations, and regulations change frequently; verify all authorities before use.