USA Identity Theft Affidavit

If you are a victim of identity theft or if some of your personal information has been compromised, you can fill out this Identity Theft Affidavit and file it with the Internal Revenue Service.

• This is Form 14039, revised December 2012.
• You must complete the affidavit according to the instructions and file it with the Department of the Treasury, by mail or by fax.
• If you have any concerns that someone may have stolen any of your confidential personal information, filing this affidavit is an important tool in fraud prevention.

The USA Identity Theft Affidavit is a free downloadable PDF form.