Identity Theft Affidavit and Police Report Cover Packet — New Mexico

IDENTITY THEFT AFFIDAVIT AND POLICE REPORT COVER PACKET — NEW MEXICO

TABLE OF CONTENTS

1. Document A — Cover Sheet for a Local Law-Enforcement Report
2. Document B — Victim Statement and Affidavit
3. Document C — FCRA Identity-Theft Block Request
4. Document D — FCRA Business-Records Request
5. Document E — New Mexico Identity Theft Passport Checklist
6. Recovery Checklist
7. Drafting and Use Notes
8. Official Sources

1. DOCUMENT A — COVER SHEET FOR A LOCAL LAW-ENFORCEMENT REPORT

[VICTIM FULL NAME]

[STREET ADDRESS]

[CITY, STATE ZIP]

[PHONE] | [EMAIL]

Date: [DATE]

To:

[LOCAL LAW-ENFORCEMENT AGENCY]

[UNIT OR CONTACT, IF KNOWN]

[ADDRESS]

Re: Request to Report Suspected Identity Theft

Dear Officer:

I request to report suspected identity theft involving my identifying information. The events are summarized in the attached Victim Statement and Affidavit.

Please record the report under the agency's current procedures and provide the following, if available:

• the report or incident number;
• instructions for obtaining a copy of the completed report;
• the investigator or unit assigned to the matter; and
• any additional information or identification the agency requires.

The suspected conduct occurred or affected me at the following locations:

I authorize the agency to submit the report and information through the current New Mexico Identity Theft Passport database process, to the extent permitted by law and agency procedure.

I understand that NMSA 1978 § 30-16-24.1 defines criminal offenses and gives a sentencing court corrective authority after a conviction. This cover sheet does not assert that the statute requires an agency to accept, certify, or investigate a report in a particular manner.

Sincerely,

[________________________________]

[VICTIM FULL NAME]

Suggested attachments: Victim Statement and Affidavit; copy of government-issued identification; account statements or credit-report pages with unrelated information redacted; correspondence from businesses; transaction records; screenshots; and a document index.

2. DOCUMENT B — VICTIM STATEMENT AND AFFIDAVIT

STATE OF NEW MEXICO

COUNTY OF [COUNTY]

I, [VICTIM FULL NAME], state as follows:

A. Victim Information

A.1. Full legal name: [NAME]

A.2. Other names used: [__________]

A.3. Date of birth: [__/__/____]

A.4. Last four digits of Social Security number: [____]

A.5. Current address: [STREET, CITY, STATE ZIP]

A.6. Prior relevant address: [STREET, CITY, STATE ZIP]

A.7. Telephone: [NUMBER]

A.8. Email: [EMAIL]

A.9. Government-issued identification presented: [TYPE / ISSUER / LAST FOUR DIGITS]

B. Discovery and Lack of Authorization

B.1. I discovered the suspected misuse on [DATE] when: [DESCRIBE FACTS].

B.2. I did not open, authorize, use, or receive the benefit of the accounts, transactions, inquiries, records, or other activity identified below, except as specifically noted.

B.3. The suspected source of the identifying information is: [UNKNOWN / LOST DOCUMENT / IMPERSONATION / PHISHING / DATA INCIDENT / OTHER].

B.4. Suspected person, address, telephone number, email, device, or other lead, if known: [__________].

C. Accounts, Transactions, and Credit-File Items

D. Other Suspected Misuse

☐ Government benefits: [DESCRIBE]

☐ Tax filing: [DESCRIBE]

☐ Employment: [DESCRIBE]

☐ Medical services or insurance: [DESCRIBE]

☐ Criminal citation, arrest, warrant, or court record: [DESCRIBE]

☐ Utility, telecommunications, housing, or rental account: [DESCRIBE]

☐ Other: [DESCRIBE]

E. Reports and Supporting Materials

F. Declaration

I declare that the information in this statement is true and correct to the best of my knowledge. I understand that a knowingly false report or affidavit may carry criminal or civil consequences.

[________________________________]

[VICTIM FULL NAME]

Date: [DATE]

Optional Notarial Certificate

Sworn to or affirmed before me on [DATE] by [VICTIM FULL NAME].

[________________________________]

Notarial Officer

Title and commission expiration: [__________]

3. DOCUMENT C — FCRA IDENTITY-THEFT BLOCK REQUEST

Prepare a separate request for each consumer reporting agency. Use the agency's current secure submission method or current designated mailing address; do not rely on an address copied from an old form.

[VICTIM FULL NAME]

[STREET ADDRESS]

[CITY, STATE ZIP]

Date: [DATE]

To:

[CONSUMER REPORTING AGENCY]

[CURRENT DESIGNATED ADDRESS OR SECURE-PORTAL REFERENCE]

Re: Request to Block Information Resulting from Identity Theft — 15 U.S.C. § 1681c-2

Dear Sir or Madam:

I request a block under 15 U.S.C. § 1681c-2 for the information identified in Attachment A. This submission includes the four items listed in § 1681c-2(a):

1. Proof of identity: [DESCRIBE ENCLOSED OR UPLOADED DOCUMENTS].

2. Identity theft report: [IDENTIFY THE ATTACHED OFFICIAL REPORT, AGENCY, DATE, AND NUMBER].

3. Identification of information to block: Attachment A identifies each account, transaction, collection item, inquiry, or other entry.

4. Consumer statement: I state that each item in Attachment A does not relate to any transaction by me.

Section 1681c-2(a) directs a consumer reporting agency, except as otherwise provided in that section, to block the reporting of the identified information not later than four business days after receiving all four items. Section 1681c-2(b) requires prompt notice to the furnisher.

Please send written confirmation of the action taken. If you decline to block or later rescind a block under § 1681c-2(c), please send the prompt notice required by that subsection and identify the reason.

I understand that § 1681c-2(c) permits a decline or rescission when the agency reasonably determines that the information or request was in error, the request relied on a material misrepresentation, or the consumer obtained goods, services, or money from the transaction.

Sincerely,

[________________________________]

[VICTIM FULL NAME]

Attachment A — Information Requested to Be Blocked

Attachments: proof of identity; identity theft report; Attachment A; supporting pages with unrelated personal information redacted.

4. DOCUMENT D — FCRA BUSINESS-RECORDS REQUEST

Use this request for the business that entered into the allegedly unauthorized transaction. Mail it to the address the business specifies for these requests, if it specifies one.

[VICTIM FULL NAME]

[STREET ADDRESS]

[CITY, STATE ZIP]

Date: [DATE]

To:

[BUSINESS ENTITY]

[CURRENT ADDRESS SPECIFIED FOR 15 U.S.C. § 1681g(e) REQUESTS, IF ANY]

Re: Identity-Theft Business-Records Request — 15 U.S.C. § 1681g(e)

Dear Sir or Madam:

I request the application and business-transaction records in your control that evidence the allegedly unauthorized transaction identified below.

Please provide the responsive records to me. I also authorize delivery to the following law-enforcement agency or officer, if applicable:

[AGENCY / OFFICER / ADDRESS / REPORT NUMBER OR "NOT REQUESTED"]

This written request includes:

• proof of my identity in the form selected or accepted by your business;
• a copy of the police report evidencing my identity-theft claim;
• a completed standardized identity-theft affidavit or other affidavit acceptable to your business; and
• the transaction information known or readily obtainable by me.

Under § 1681g(e)(1), responsive application and business-transaction records in the business's control are due not later than 30 days after receipt of a request that satisfies § 1681g(e)(2)-(3). Section 1681g(e)(4) requires the records to be provided without charge.

Please identify any additional verification or transaction information needed to process this request.

Sincerely,

[________________________________]

[VICTIM FULL NAME]

Attachments: identification; police report; Victim Statement and Affidavit; transaction information; authorization for any law-enforcement recipient.

Statutory Limits to Preserve in Use

• Section 1681g(e) does not require a business to obtain, retain, or maintain records it does not otherwise keep.
• A business may decline Internet navigational data or similar website-visit information.
• The subsection lists other good-faith grounds to decline, including insufficient identity confidence and material misrepresentation.
• Sections 1681n and 1681o expressly do not apply to a violation of § 1681g(e), except as provided in § 1681s. Do not add a contrary private-liability threat to this letter.

5. DOCUMENT E — NEW MEXICO IDENTITY THEFT PASSPORT CHECKLIST

Current routing: New Mexico Department of Justice guidance states that a victim first files a report with local law enforcement, the report and victim information enter the statewide Identity Theft Passport database, and passports can be received only at a New Mexico Motor Vehicle Division office. This is a workflow checklist, not a mailed application to the Attorney General.

☐ File the local law-enforcement report and retain its number and a copy, if available.

☐ Ask the reporting agency how the report and victim information enter the statewide Identity Theft Passport database.

☐ Contact a New Mexico MVD office before visiting to confirm the current office, appointment, fingerprint, identification, fee, and document procedures.

☐ Bring a driver's license or other government-issued identification or record.

☐ Bring or arrange a full set of fingerprints if the current process requires the fingerprint route.

☐ If relying on an existing certified order obtained under former NMSA 1978 § 31-26-16 before its repeal, bring the certified copy and confirm acceptance with MVD.

☐ Provide any other information currently required by the Attorney General and MVD.

☐ Retain copies of everything submitted and record the office, date, and staff contact.

NMSA 1978 § 31-26-15 allows qualification with either a certified order obtained under the former § 31-26-16 process or a full set of fingerprints, together with government-issued identification and other information required by the Attorney General. Section 31-26-16 was repealed effective January 1, 2020; this packet does not instruct a victim to seek a new order under that repealed section.

6. RECOVERY CHECKLIST

☐ Report identity theft and obtain a personal recovery plan at the current FTC IdentityTheft.gov site.

☐ Request an initial fraud alert if appropriate. Under § 1681c-1(a), an initial alert is based on a good-faith suspicion and proof of identity; an identity theft report is not listed as a condition.

☐ Request an extended fraud alert if appropriate. Under § 1681c-1(b), the consumer must submit an identity theft report and proof of identity.

☐ Consider a security freeze separately from a fraud alert.

☐ File a local law-enforcement report if pursuing the New Mexico passport workflow, seeking business records under § 1681g(e), or otherwise appropriate.

☐ Send a complete § 1681c-2 block request to each relevant consumer reporting agency.

☐ Send a complete § 1681g(e) records request to each business that entered into an allegedly unauthorized transaction.

☐ Notify affected financial institutions, creditors, government programs, insurers, employers, or other entities through their current fraud channels.

☐ Preserve complete copies, submission confirmations, delivery records, responses, and a communication log.

☐ Review later consumer reports and responses; identify any item that remains inaccurate or reappears.

7. DRAFTING AND USE NOTES

• New Mexico criminal statute: NMSA 1978 § 30-16-24.1 defines theft of identity and obtaining identity by electronic fraud as fourth-degree felonies. Restitution and the sentencing court's written findings and possible corrective orders arise after a person is found guilty. The section does not create a victim-facing police-report acceptance or certification procedure.
• New Mexico passport: Section 31-26-15 governs the passport and database. Current NMDOJ guidance routes reporting through local law enforcement and receipt of the passport through MVD.
• Repealed order procedure: Section 31-26-16 is repealed. Its former court-order process must not be promoted as a current filing route.
• Federal report distinctions: Section 1681a(q)(4) defines an identity theft report as, at minimum, an official valid report filed with an appropriate federal, state, or local law-enforcement agency or another government agency deemed appropriate by the Bureau, alleging identity theft and carrying false-filing consequences. A police report is therefore not a universal prerequisite to every federal identity-theft step.
• FCRA block: The four-business-day period in § 1681c-2 begins after the consumer reporting agency receives all four statutory items. Preserve the statute's decline-and-rescission rules.
• Business records: Section 1681g(e) is limited to application and transaction records within the business's control. Preserve its verification, delivery, no-charge, decline, recordkeeping, and remedy limitations.

8. OFFICIAL SOURCES

• New Mexico Statutes Annotated, Chapter 30 (including § 30-16-24.1): https://nmonesource.com/nmos/nmsa/en/4371/1/document.do
• New Mexico Statutes Annotated, Chapter 31 (including §§ 31-26-15 and 31-26-16): https://nmonesource.com/nmos/nmsa/en/4379/1/document.do
• New Mexico Department of Justice, Scam Prevention and Identity Theft: https://nmdoj.gov/get-help/scam-prevention-and-identity-theft/
• Office of the Law Revision Counsel, 15 U.S.C. § 1681c-1: https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681c-1&num=0&edition=prelim
• Office of the Law Revision Counsel, 15 U.S.C. § 1681c-2: https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681c-2&num=0&edition=prelim
• Office of the Law Revision Counsel, 15 U.S.C. § 1681g: https://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title15-section1681g&num=0&edition=prelim
• U.S. Government Publishing Office, 15 U.S.C. § 1681a: https://www.govinfo.gov/content/pkg/USCODE-2024-title15/html/USCODE-2024-title15-chap41-subchapIII-sec1681a.htm
• Federal Trade Commission, IdentityTheft.gov: https://www.identitytheft.gov/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in New Mexico must review and customize this document before use. Laws, citations, agency procedures, and submission channels change; verify them before use.