Identity Theft Affidavit and Police Report Cover Packet (New Jersey)

IDENTITY THEFT AFFIDAVIT AND POLICE REPORT COVER PACKET — NEW JERSEY

TABLE OF CONTENTS

1. Quick-Action Checklist
2. Document A — Police Report Cover Letter (Local NJ Agency)
3. Document B — Identity Theft Affidavit
4. Document C — FCRA § 605B Blocking Request to Credit Bureaus
5. Document D — Furnisher / Creditor Dispute Letter
6. New Jersey Practice Notes
7. Sources and References

1. QUICK-ACTION CHECKLIST

Within 24-72 hours of discovery, complete the following:

☐ Place an initial fraud alert (free, 1-year) with one of the three nationwide CRAs (it will notify the other two). Eligible victims may extend to a 7-year fraud alert with a police report.

☐ Place a security freeze at Equifax, Experian, and TransUnion (free under N.J.S.A. § 56:11-46 and federal law).

☐ File an FTC report at IdentityTheft.gov to obtain an FTC Identity Theft Report.

☐ File a local police report in your NJ municipality of residence (N.J.S.A. § 2C:21-17.6 — local agency must accept).

☐ Notify your bank, card issuers, and any account custodians in writing.

☐ Notify the SSA if your Social Security Number was misused (1-800-269-0271 OIG hotline).

☐ Notify the IRS if your SSN was used to file a fraudulent tax return (Form 14039).

☐ File a complaint with the New Jersey Division of Consumer Affairs (973-504-6200; njconsumeraffairs.gov).

☐ Demand business records under 15 U.S.C. § 1681g(e) from each entity that opened or extended fraudulent credit.

☐ Keep a written log of every call, letter, and contact (date, time, name, phone, outcome).

2. DOCUMENT A — POLICE REPORT COVER LETTER (LOCAL NJ AGENCY)

[VICTIM'S FULL LEGAL NAME]

[VICTIM'S NJ STREET ADDRESS]

[CITY, NJ ZIP]

[VICTIM'S PHONE]

[VICTIM'S EMAIL]

Date: [__/__/____]

[NAME OF LOCAL POLICE DEPARTMENT]

Attn: Records / Detective Bureau

[STREET ADDRESS]

[CITY, NJ ZIP]

RE: REQUEST TO FILE IDENTITY THEFT POLICE REPORT — N.J.S.A. § 2C:21-17.6

To the Officer in Charge:

I am a resident of [CITY/TOWNSHIP], [COUNTY] County, New Jersey. I have a reasonable belief and reasonable suspicion that I have been the victim of identity theft in violation of N.J.S.A. § 2C:21-17 (Impersonation; theft of identity).

Pursuant to N.J.S.A. § 2C:21-17.6, I respectfully request that this Department:

1. Take a police report of this matter;

2. Provide me with a copy of the report (and a report number) for use with consumer reporting agencies, creditors, and other affected entities, as required by 15 U.S.C. § 1681a(q)(4) and 15 U.S.C. § 1681c-2; and

3. Refer the complaint to any other law enforcement agency with investigative jurisdiction as appropriate.

I understand that pursuant to N.J.S.A. § 2C:21-17.6, this Department is required to take this report even if the underlying conduct may have occurred — or jurisdiction may lie — outside this municipality.

Summary of the Identity Theft

Narrative

[Provide a chronological narrative of the discovery, the affected accounts/services, any contact with the suspect, and steps already taken (fraud alerts, freezes, FTC report, etc.). Attach supporting documents.]

Attachments

☐ Government-issued photo ID

☐ Proof of NJ residency (utility bill, lease, etc.)

☐ FTC Identity Theft Report (IdentityTheft.gov)

☐ Copies of fraudulent account statements / collection notices

☐ Identity Theft Affidavit (Document B, attached and notarized)

☐ Other: [________]

I am happy to come to the Department in person, provide additional documentation, or be interviewed by a detective. Please contact me at the phone or email above to confirm receipt of this report and to provide a report number.

Thank you for your assistance.

Sincerely,

[________________________________]

[VICTIM'S FULL LEGAL NAME]

3. DOCUMENT B — IDENTITY THEFT AFFIDAVIT

STATE OF NEW JERSEY

COUNTY OF [COUNTY]

I, [VICTIM'S FULL LEGAL NAME], of full age, being duly sworn according to law, depose and state:

Identity of Affiant

1. My full legal name is [NAME].

2. I currently reside at [NJ STREET ADDRESS, CITY, ZIP], in [COUNTY] County, New Jersey.

3. My date of birth is [__/__/____].

4. The last four digits of my Social Security Number are [XXX-XX-____].

5. My telephone number is [NUMBER] and my email is [EMAIL].

Statement of Facts

6. I am the victim of identity theft as defined by 18 U.S.C. § 1028 and N.J.S.A. § 2C:21-17.

7. On or about [__/__/____], I discovered that [describe how discovered — e.g., received a collection notice, found unknown account on credit report, denied credit, received IRS letter].

8. Upon investigation, I learned that the following accounts, transactions, or instruments were opened, used, or attempted in my name without my knowledge, consent, or authorization:

9. I did not authorize, ratify, or benefit from any of the transactions listed above.

10. I have not knowingly given anyone permission to use my name, Social Security Number, date of birth, driver's license, or any other personal identifying information to apply for, open, or use the accounts listed above.

11. To the best of my knowledge, the person(s) responsible for the identity theft is/are: [NAME, RELATIONSHIP, OR "UNKNOWN"].

12. [If a relative, household member, or known person:] Although I know the suspect, I did not consent to the use of my identity, and I [do / do not] intend to pursue criminal prosecution.

13. I have taken the following remediation steps:

a. ☐ Filed an FTC Identity Theft Report at IdentityTheft.gov on [__/__/____] (Report No. [________]);

b. ☐ Filed a police report with [POLICE DEPARTMENT] on [__/__/____] (Report No. [________]);

c. ☐ Placed a fraud alert with the nationwide consumer reporting agencies on [__/__/____];

d. ☐ Placed a security freeze with Equifax, Experian, and TransUnion on [__/__/____];

e. ☐ Notified each affected creditor or business in writing;

f. ☐ Filed a complaint with the New Jersey Division of Consumer Affairs on [__/__/____];

g. ☐ Other: [________].

Requests Pursuant to Federal and New Jersey Law

14. I request that the recipient business or consumer reporting agency:

a. Block all information resulting from the identity theft from my consumer file pursuant to FCRA § 605B, 15 U.S.C. § 1681c-2;

b. Cease reporting the disputed tradelines to consumer reporting agencies;

c. Provide me, free of charge, copies of all applications and business transaction records relating to the fraudulent accounts, pursuant to FCRA § 609(e), 15 U.S.C. § 1681g(e);

d. Notify any debt collector to whom the disputed debt was assigned that the debt resulted from identity theft;

e. Close any accounts opened fraudulently in my name and confirm closure in writing.

Verification

15. I declare under penalty of perjury under the laws of the State of New Jersey and the United States that the foregoing is true and correct.

[________________________________]

[VICTIM'S FULL LEGAL NAME]

Date: [__/__/____]

Sworn to and subscribed before me this [____] day of [_______________], 20[____].

[________________________________]

Notary Public, State of New Jersey

(My Commission Expires: [_______________])

4. DOCUMENT C — FCRA § 605B BLOCKING REQUEST TO CREDIT BUREAUS

[VICTIM NAME / ADDRESS / DATE — same as above]

To: [Equifax / Experian / TransUnion] — Identity Theft Department

RE: REQUEST FOR BLOCK OF INFORMATION RESULTING FROM IDENTITY THEFT — 15 U.S.C. § 1681c-2

Dear Identity Theft Department:

I am a victim of identity theft. Pursuant to FCRA § 605B, 15 U.S.C. § 1681c-2, I request that you block from my consumer file the information identified below, which resulted from the alleged identity theft.

In support of this request, I am enclosing:

1. ☐ A copy of my FTC Identity Theft Report (Report No. [________]);

2. ☐ A copy of my police report filed with [POLICE DEPARTMENT] under N.J.S.A. § 2C:21-17.6 (Report No. [________]);

3. ☐ A copy of my government-issued photo identification;

4. ☐ A copy of a utility bill or other document verifying my current address;

5. ☐ My notarized Identity Theft Affidavit (Document B);

6. ☐ A specific identification of the information to be blocked (table below); and

7. ☐ A statement that the information is not the result of any transaction by me.

Information to be blocked

I certify that the above information does not relate to any transaction made or authorized by me.

Please confirm in writing within four (4) business days of receipt that the block has been implemented, as required by 15 U.S.C. § 1681c-2(a). Please also notify each furnisher of the disputed information of the block per 15 U.S.C. § 1681c-2(b).

Sincerely,

[________________________________]

[VICTIM NAME]

5. DOCUMENT D — FURNISHER / CREDITOR DISPUTE LETTER

[VICTIM NAME / ADDRESS / DATE]

To: [CREDITOR NAME] — Fraud Department

[ADDRESS]

RE: IDENTITY THEFT — DEMAND FOR ACCOUNT CLOSURE, BLOCKING, AND BUSINESS RECORDS

Account: [ACCOUNT NUMBER — LAST 4]

Dear Fraud Department:

I am the victim of identity theft. The above-referenced account was opened or transacted without my knowledge, consent, or authorization. I demand the following:

1. Immediate closure of the account and confirmation in writing;

2. Cessation of all collection activity and recall of any account from any third-party debt collector;

3. Removal of the account from any consumer report you have furnished, and notification to all consumer reporting agencies that the account is the result of identity theft;

4. Production of business records under FCRA § 609(e), 15 U.S.C. § 1681g(e), including:

a. The application for the account (and any signatures);

b. All statements, transaction records, and payment records;

c. Any IP address, device ID, or telephone number used to open or transact on the account;

d. Any audio recordings or chat transcripts associated with the account;

e. The shipping addresses and recipients for any goods purchased.

Records must be provided within thirty (30) days of receipt of this letter pursuant to 15 U.S.C. § 1681g(e)(1).

Enclosed are my notarized Identity Theft Affidavit, FTC Identity Theft Report, NJ police report, and government ID.

I reserve all rights under the FCRA, the FDCPA, the New Jersey Consumer Fraud Act (N.J.S.A. § 56:8-1 et seq., providing mandatory treble damages, attorneys' fees, and costs), and the New Jersey Identity Theft Prevention Act (N.J.S.A. § 56:11-44 et seq.).

Sincerely,

[________________________________]

[VICTIM NAME]

6. NEW JERSEY PRACTICE NOTES

• Local NJ police report mandatory acceptance. N.J.S.A. § 2C:21-17.6 requires the local police agency of the victim's residence to take a report even when investigative jurisdiction lies elsewhere. Cite the statute if the desk officer initially refuses.
• NJ Identity Theft Prevention Act (ITPA). N.J.S.A. § 56:11-44 et seq. governs security freezes, free credit-report access for victims, and breach notification obligations of NJ businesses (N.J.S.A. § 56:8-161 et seq.).
• Free security freezes. Federal law (Economic Growth, Regulatory Relief, and Consumer Protection Act of 2018) plus N.J.S.A. § 56:11-46 make security freezes free in NJ. Place freezes online at each CRA's portal — no written request required, but written request is recommended for paper trail.
• FCRA blocking — 4-business-day clock. A CRA must implement a § 605B block within 4 business days of receiving (i) an Identity Theft Report, (ii) ID, (iii) identification of the information, and (iv) the consumer's statement that the information is not from a transaction by the consumer. 15 U.S.C. § 1681c-2(a).
• FCRA business records demand. Under § 609(e), any business that opened or extended credit must provide application and transaction records to the victim within 30 days of a written request. 15 U.S.C. § 1681g(e). Many businesses do not respond — follow up in writing and consider FCRA litigation if non-compliant.
• Furnisher duties on ID-theft reports. Once a furnisher receives an Identity Theft Report directly from the consumer, it may not furnish the disputed information. 15 U.S.C. § 1681s-2(a)(6).
• NJCFA leverage. Where a creditor or debt collector refuses to act on a verified identity-theft affidavit and continues to collect or report, consider an NJCFA claim — the unconscionable commercial practice plus an ascertainable loss (collection fees, time, harm to credit) triggers mandatory treble damages and attorneys' fees under N.J.S.A. § 56:8-19.
• Tax-related ID theft. File IRS Form 14039 (Identity Theft Affidavit) and request an Identity Protection PIN.
• SSN misuse. Contact the SSA OIG fraud hotline at 1-800-269-0271. Do not request a new SSN unless absolutely necessary — it can complicate credit history.
• Statute of limitations on civil claims. FCRA: 2 years from discovery, max 5 years from violation (15 U.S.C. § 1681p). NJCFA: 6 years.
• Criminal restitution. N.J.S.A. § 2C:21-17(d) authorizes the sentencing court to order restitution to the victim and to issue orders correcting public records.

7. SOURCES AND REFERENCES

• N.J.S.A. § 2C:21-17 — https://law.justia.com/codes/new-jersey/title-2c/section-2c-21-17/
• N.J.S.A. § 2C:21-17.6 (local police report duty) — https://law.justia.com/codes/new-jersey/title-2c/section-2c-21-17-6/
• New Jersey Identity Theft Prevention Act, N.J.S.A. § 56:11-44 et seq. — https://law.justia.com/codes/new-jersey/title-56/section-56-11-44/
• NJ Identity Theft Prevention Act PDF — https://www.njconsumeraffairs.gov/Statutes/Identity-Theft-Prevention-Act.pdf
• New Jersey Division of Consumer Affairs — Identity Theft — https://www.njconsumeraffairs.gov/ocp/Pages/identitytheft.aspx
• FCRA § 605B (blocking) — https://www.law.cornell.edu/uscode/text/15/1681c-2
• FCRA § 609(e) (business records) — https://www.law.cornell.edu/uscode/text/15/1681g
• FTC IdentityTheft.gov — https://www.identitytheft.gov/
• IRS Form 14039 — https://www.irs.gov/forms-pubs/about-form-14039
• N.J.S.A. § 56:8-161 et seq. (Data breach notification)
• New Jersey Consumer Fraud Act — https://www.njconsumeraffairs.gov/statutes/consumer-fraud-act.pdf

Disclaimer: This packet is provided for informational purposes only and does not constitute legal advice. Identity theft cases often involve overlapping criminal, civil, and tax issues; consult a New Jersey-licensed attorney where significant losses, judgments, or criminal records are involved.