[YOUR FULL LEGAL NAME]
[YOUR STREET ADDRESS]
[CITY, STATE ZIP]

[DATE]

[CREDIT BUREAU NAME]
[CREDIT BUREAU ADDRESS FOR IDENTITY THEFT / BLOCK REQUESTS]

Sent by certified mail, return receipt requested

RE: Request to block information resulting from identity theft

To whom it may concern:

I am a victim of identity theft. I am requesting that you block the reporting of
the information identified below, which resulted from that identity theft.

In support of this request I am submitting all of the following:

1. Proof of my identity (see enclosures).
2. A copy of my identity theft report (see enclosures).
3. Identification of the information resulting from the identity theft, set out
   below.
4. My statement, below, that the information does not relate to any transaction
   by me.

INFORMATION TO BE BLOCKED
Company shown on the report: [COMPANY NAME AS IT APPEARS]
Account number as shown: [PARTIAL ACCOUNT NUMBER AS PRINTED]
As reported: [Quote exactly what the report says.]
Date it first appeared on my report: [DATE]

[Repeat this block for each item. Identify every item you want blocked — the
request covers what you identify, so an item you do not list is not included.]

MY STATEMENT
The information identified above is not information relating to any transaction
by me. [Add the facts: when and how you discovered the theft, what you did, and
anything that shows you did not open or use the account.]

REQUESTED ACTION
Block the reporting of the information identified above and notify the furnisher
of that information of the block. Please confirm the block to me in writing.

MY IDENTIFYING INFORMATION
Full legal name: [YOUR FULL LEGAL NAME]
Date of birth: [MONTH DAY, YEAR]
Last four of Social Security number: [LAST FOUR DIGITS ONLY]
Current address: [YOUR ADDRESS]
Previous address (if you moved in the last two years): [PREVIOUS ADDRESS]

ENCLOSURES
1. [Copy of government-issued photo ID]
2. [Copy of a utility bill or bank statement showing your current address]
3. [Copy of your identity theft report]
4. [Copy of the credit report with each item circled]
5. [Any police report, FTC report, or affidavit]

Sincerely,


_______________________________
[YOUR FULL LEGAL NAME]


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NOTES — DELETE THIS SECTION BEFORE SENDING

* All four items must be included. The statutory 4-business-day period runs from
  receipt of the complete set, so an incomplete submission does not start it.
  Send them together, in one envelope, and list them in the letter.
* "Identity theft report" is a defined term under the FCRA, and not every
  document a consumer thinks of as a report satisfies it. Consumers commonly
  obtain one through IdentityTheft.gov, a police report, or both. Because the
  definition controls and the consequences of getting it wrong are real, this is
  a good point at which to talk to a lawyer before sending anything.
* Do not assert that something is fraudulent unless you know that it is. A block
  requested on a material misrepresentation of the facts can be declined or
  rescinded.
* Place a security freeze at all three bureaus at the same time. It is free, and
  it is what actually stops the next fraudulent account.
* Notify the furnishers directly as well. The bureau block addresses your file;
  the furnisher still holds an account in your name.

This template is general information, not legal advice, and it has not been
reviewed against your particular situation. Credit File Corrections is not a
law firm. Read every line and edit it so that it is accurate for you before you
sign and send it. Sending this letter is what makes the request — nothing you do
on our website submits anything to anyone.

Related guide: https://creditfilecorrections.com/disputes/identity-theft-block/
Statutory framework: 15 U.S.C. § 1681c-2
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