Written comments should be received on or before april 8, 2019 to be assured of consideration. Financial institutions and law enforcement authorities may both require these affidavits after a crime has been committed. Identity theft victims complaint and affidavit a voluntary form for filing a report with law enforcement, and disputes with credit reporting agencies and creditors about identity theftrelated problems. I understand that this forgery is subject to investigation by local, state andor federal law enforcement. I understand this forgery is subject to investigation by local, state andor federal law enforcement agencies. Th is affidavit is made voluntarily for the purpose of establishing the fact t hat my signature is a forgery. Known either as an affidavit of forgery or a forgery affidavit, these legal documents are completed by a person who has been the victim of identity fraud. Muris, the chairman of the federal trade commission. The affidavit will be completed by the alleged fraud victim and is generally required to be signed in the presence of notary public or other official capable of. Claim to lost, stolen or destroyed cashiers check, tellers check or certified check html file.
Affidavit of forgery allsouth federal credit union. Three notarized original affidavits are required for each forgery request. Street city state zip code best number to reach you the checks listed below were neither written, nor authorized, by me or names related to the above mentioned account and are either forgeryaltered. Identity theft affidavit forms are important for the following reasons. Before returning a fraudulent check for any type of forgery, we require the completed forgery affidavit to be scanned to the operations department before the check is returned, and the original follows later. I did not receive any part of the proceeds of the checks listed above. It is used to state some facts regarding marriage, divorces, births and change of names. No if yes, provide details on a separate page or the back of this page. The affidavits need to be attested by a certain person with a legal background. I understand this forgery is subject to investigation by local, state andor federal law enforcement. In order to dispute a check that has a forged endorsement, signature, or other alteration made after the final possession by the drawer. Federal trade commission announces id theft affidavit.
The checks are an imitation of checks drawn on my account. A collection of various posters and forms including the indemnity letter from barbara hurst at bankers hotline which you can adapt and use in instances where you are willing to take a business risk in connection with paying checks only if the customer is contractually obligated to indemnify you against losses or claims. I understand that this forgery is subject to investigation by local, state andor federal law enforcement agencies. Yes no if yes, please provide details on the back of this page or attach a separate page. To be completed by the person alleging the forgery california only, notary. Affidavit attesting to forgery 3 4 before the undersigned, an officer duly authorized to take acknowledgement, personally apppeared the claimant who, being duly sworn, deposes and says that the claimant see below is payee of a certain state warrant as. Cut along the appropriate lines before presenting deposit. I did not receive any part of the proceeds affidavit is made voluntarily for the purpose of establishing the fact that my signature is a forgery. The affidavit will be completed by the alleged fraud victim and is generally required to be signed in the presence of notary public or other official capable of authenticating the victims signature. The endorsement on the reverse of the items described below is a forgery, missing, or not as drawn.
Apr 30, 2020 a forgery affidavit is a legal document that is filled out and signed by a consumer who became a victim to a type of identity fraud. I give my consent to the credit union to release any information regarding my account to any local, state andor federal law enforcement agency. Signature i understand this forgery is subject to investigation by local, state andor federal law enforcement agencies. All requests must be accompanied by a pocs affidavit of forgery form.
The affiant noted below, and evidenced by hisher signature, does affirm that the instruments listed and described. Affidavit of forgery see the detailed instructions listed below for completing tl1is form copy ofthe police report or incident number copy ofthe items in question. Fraud affidavit form please contact the payment operations center poc concerning matters of check fraud. This form is to be used when a client swears a warrant with their signature on it is a forgery. Show factual information every type of affidavit form differs on where it is intended to be submitted and what information will be collected in it. I did not receive any part of the instruments listed above. These documents are used for various purposes, and you. Date instrument number dollar amount a b c if more space is required, use a separate sheet 6.
Yes no if yes, provide details on a separate page or the back of this page. This free printable can be attested to and signed by a notary public. Currently the bureau of the fiscal service within the department of the treasury is soliciting comments concerning the affidavit of forgery for united states bondsnotes. An affidavit is a written document that contains a swearing by a particular person and is legally recognized by the court. Oto forgery affidavit is maintained on the treasury server at databankingbank fraud. It may also ask for the amount for which the check was written. Member information first flight federal credit union. Yes no if yes, provide the details on a separate page or on the back of this page.
Free affidavit of forgery template pdf word eforms. I further agree to assist the owensboro police department in any investigation and criminal prosecution by testifying for the commonwealth of kentucky in court to the facts stated herein. Both financial institutions and police departments use this statement as evidence that a crime has been committed, and when they enter either civil or criminal court to seek prosecution, a forgery affidavit is required among the original documents filed. An affidavit of forgery is a statement attesting that a document has been fraudulently produced using a forged signature. Provide a detailed statement of what occured on page 2. In order to dispute a check that has a forged endorsement, signature, or other alteration made after the final possession by the drawer, please fill out this form in its entirety and have it notarized by a notary public.
Printable affidavit of forgery legal pleading template. This affidavit is made voluntarily for the purpose of establishing the fact that my signature has been forged. Affidavit of forgery when dealing with a forged check or draft, many people need to have an official record denouncing the signature and any connection to it. This affidavit is made voluntarily for the purpose of establishing the fact that my signature is a forgery. The deposit slip form is for state agencies when making deposits to the banking and electronic processing division. Notary services are available in branch or by private notary.
My endorsement on the reverse of the checks listed below is a forgery, missing or not as drawn. When it comes to an identity theft affidavit form, the details of how the affiant determined or found out about the incident will be stated along with his particulars. I am first duly sworn and state i am name address city state zip home phone work phone 2. I understand this forgery is subject to investigation by local, state, andor state andor federal law enforcement agencies.
Regular vendor single vendor employee travel and expense agency information all fields must be completed. Complete the identity theft report online at the website of the federal trade commission ftc at identitytheft. I did not endorse the checks and i did not authorize the endorsement. Check fraud claim affidavit of unauthorized action by. A typical affidavit of forgery will include your state and county, your name, and space to identify what it was, particularly, that was stolen and forged, such as a specific check number. Form 00952, affidavit of forgery pdf form 00953, affidavit and indemnity agreement for lost warrant pdf deposit slip. Important the person alleging forgery must complete this form in long hand. Yes provide details on a separate sheet or reverse side of this form no 7.
Do you know who forged your signature or has possession of your checks. Request for stop payment, replacement check, photocopy of check, or forgery affidavit td346 320 check type mark an x in the applicable box. Yes no if yes, provide details on the back of this page. I am first duly sworn and under penalties of perjury state the following. Street city state zip code best number to reach you the checks listed below were neither written, nor authorized, by me or names related to the above mentioned account and are either forgery altered. Download the affidavit of forgery or altered ltem form pdf all requests must be accompanied by a pocs affidavit of forgery form. Print out of the members history showing the item clearing. Id thieves steal personal information, such as a credit card account number or social. Affidavit of forgery complete this form in longhand. A signed and completed identity theft report or identity theft fraud and forgery declaration form. If it is a joint account, each party must complete and sign an affidavit. I did not sign the checks and i did not authorize the signature.
The person alleging forgery or alteration of an instrument or an unauthorized instrument must complete this form in their own writing. If more space is required, please use a separate sheet. To be completed by the person alleging the forgery all states. I did not receive any part of the proc eeds of the instruments listed above. I did not receive any part of the proceeds of the instruments listed above. During 2001, id theft was the number one consumer fraud complaint received by the ftc, stated timothy j. This affidavit of forgery is submitted by the undersigned to the bank of new york mellon in support of the undersigneds claim that certain checks of the undersigned drawn on a health savings account were im properly paid over a forged signatures. I am first duly sworn and state i am name mailing address city, state, zip phone number home work 2.
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