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Ftb 3552 Template

The FTB 3552 form is designed specifically for individuals in California who suspect they are victims or potential victims of identity theft and seek to alert the Franchise Tax Board (FTB) to potentially fraudulent activity on their tax accounts. It provides a structured way for taxpayers to report incidents affecting their tax status due to identity theft, offering them a means to submit detailed information and documentation to the FTB for investigation. For those needing to safeguard their tax accounts and personal information, completing and submitting this form, alongside the required identity verification documents, is a critical step. Click the button below to learn more about how to correctly fill out and submit the FTB 3552 form.

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Table of Contents

For individuals grappling with the consequences of identity theft, especially where it pertains to tax issues, the State of California provides a pivotal resource in the form of the FTB 3552 form. This affidavit is designed to help victims or those at potential risk of identity theft in alerting the Franchise Tax Board (FTB) about their concern for questionable activities on their tax accounts. Any resident of California who believes their tax account has been compromised or could potentially be at risk due to lost or stolen personal information can file this form. It requires individuals to specify whether they are reporting an actual identity theft incident or are at risk of future impact to their tax account. The form also asks for details such as the tax year(s) impacted, the date of the incident, last tax return filed, and the last four digits of the individual's Social Security Number or their complete Individual Taxpayer Identification Number. Additional instructions are provided for how to submit the necessary documentation, such as a copy of a passport or driver’s license, to verify one's identity alongside the affidavit. This process includes options for submission by mail or fax, along with assurances that the FTB does not contact taxpayers via email or fax for such matters, underlining the importance of privacy and security. As identity theft can have significant and lasting effects on one's financial wellbeing and tax responsibilities, the availability and correct completion of the FTB 3552 form stand as essential steps towards regaining control over one’s personal information and tax account status.

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STATE OF CALIFORNIA

FILING COMPLIANCE BUREAU MS F151

FRANCHISE TAX BOARD

PO BOX 1468

SACRAMENTO CA 95812-1468

Identity Theft Affidavit

Complete and submit this form if you are an actual or potential victim of identity theft and would like the Franchise Tax Board (FTB) to update your account status to identify questionable activity.

Check one of the following boxes:

I am a victim of identity theft, and I believe this incident is affecting my tax account. Provide a short explanation of the tax impact:

I am a victim of identity theft, and I believe I may be at risk for future impact to my tax account.

I am a potential victim of identity theft, and I believe I may be at risk for future impact to my tax account. (Check “potential victim” if you have not experienced identity theft but are at risk due to a lost/stolen purse or wallet, questionable credit card or credit report activity, etc.)

Tax Year(s) Impacted

Date the Incident Occurred

Last Tax Return Filed (Year)

Provide the last 4 digits of your Social Security Number or

(if applicable or known):

(if applicable or known):

(Enter NRF if Not Required to File.):

your complete Individual Taxpayer Identification Number:

 

 

 

 

 

Last Name:

 

First Name:

 

Middle Initial:

 

 

 

 

 

Current Mailing Address:

 

 

 

 

City:

State:

 

 

Address on Last Tax Return Filed (Check Here If You Are Not Required to File a Tax Return.):

ZIP Code:

City:

State:

ZIP Code:

 

 

 

 

Telephone Number: Home Work Cell

Best Time (s) to Call:

Primary Language: English Spanish Other

 

 

Specify:

 

 

 

 

 

Under penalty of perjury, I declare that, to the best of my knowledge and belief, the information entered in this form is true, correct, complete, and made in good faith. I hereby agree and consent that the facsimile/fax signature of this affidavit shall be considered as valid as the original.

Taxpayer Signature

Date Signed (mm/dd/yyyy)

Submit this completed form and a copy of at least one of the following documents to verify your identity.

(Check the box next to the document you are submitting.)

a) Passport

b) Driver license or Department of Motor Vehicles identification card

If available, include a copy of:

c) Social security card

d) Police report

e) Internal Revenue Service letter of determination

Submit the copies required above with this form using one of the options described on PAGE 2 of this form.

FTB 3552 (REV 06-2016) C1 PAGE 1

355200081371

Submit the copies required above with this form using one of the options described on PAGE 2 of this form.

By Mail:

By Fax:

 

 

If you received a notice from FTB, return this

If you received a notice in the mail from FTB and a fax

form with a copy of the notice to the address

number is shown, fax this completed form with a copy of

contained in the notice.

the notice to that number. Include a cover sheet marked

 

“Confidential.” If no fax number is shown, follow the mailing

If you have not received an FTB notice and are

instructions.

self-reporting potential risk for future impact to

 

your tax account, mail this form to:

FTB does not initiate contact with taxpayers by email or fax.

FILING COMPLIANCE BUREAU MS F151

If you have not received an FTB notice and are self-reporting

FRANCHISE TAX BOARD

potential risk for future impact to your tax account, fax this form

PO BOX 1468

to:

SACRAMENTO CA 95812-1468

 

 

916.843.0561

 

 

Go to oag.ca.gov and search for identity theft for additional resources and information regarding identity theft.

For privacy information, go to ftb.ca.gov and search for privacy notice. To request this notice by mail, call 800.338.0505 and enter form code 948 when instructed.

Connect With Us

Web: ftb.ca.gov

Phone:

916.845.7088

 

7 a.m. to 5 p.m. weekdays, except state holidays

 

 

916.845.6500

 

from outside the United States

 

 

 

TTY/TDD: 800.822.6268

for persons with hearing or speech impairments

FTB 3552 (REV 06-2016) C1 PAGE 2

Form Breakdown

Fact Detail
Form Name FTB 3552
Form Purpose Identity Theft Affidavit
Issuing Agency Franchise Tax Board, State of California
Intended Users Actual or potential victims of identity theft concerned about their tax account
Governing Law California Revenue and Taxation Code
Key Contents Information on taxpayer's identity, description of identity theft incident, and required documentation for verification
Submission Methods By mail or fax, with specific instructions provided for each
Support Documents Passport, Driver license, DMV ID card, Social Security card, Police report, IRS letter of determination
Contact Information Available options include mail, fax, web, phone, and TTY/TDD for hearing or speech impairments

Guidelines on Filling in Ftb 3552

After discovering you might be a victim of identity theft, completing the FTB 3552 form is vital. This process notifies the California Franchise Tax Board of your situation, allowing them to flag your account for any suspicious activities. Ensuring accurate and complete information is crucial to protecting your tax account from potential fraud. The steps below guide you through the form completion process, alongside selecting the proper method of submitting your form and the necessary identity verification documents.

  1. Decide which type of victim you are: a victim suspecting an effect on your tax account, a victim concerned about future risks to your tax account, or a potential victim anticipating future risks due to incidents like a lost or stolen wallet. Check the appropriate box.
  2. Enter the tax year(s) affected by the identity theft.
  3. Provide the date the identity theft incident occurred, if known.
  4. Specify the last year you filed your tax return, entering 'NRF' if you were not required to file.
  5. Fill in the last four digits of your Social Security Number (SSN) or your complete Individual Taxpayer Identification Number (ITIN), whichever is applicable.
  6. Complete the personal information section with your last name, first name, and middle initial.
  7. List your current mailing address, including city, state, and ZIP Code.
  8. If different from your current address, provide the address from your last tax return. Check the box if you are not required to file a tax return.
  9. Give your contact number and indicate whether it's a home, work, or cell phone number. Also, mention the best times to call you.
  10. Choose your primary language of communication from the options provided or specify another if not listed.
  11. Sign and date the form, declaring under penalty of perjury that the information provided is true and correct to the best of your knowledge. Agree and consent that a faxed signature on this affidavit is as valid as the original.
  12. Select the form of identification you are submitting with this form by checking the appropriate box next to the document: passport, driver license or Department of Motor Vehicles identification card, social security card, police report, or IRS letter of determination. Include at least one of these documents for identity verification.

Once the form and documentation are ready, decide on your submission method. If you have received a notice from the Franchise Tax Board, return this form and a copy of the notice to the address provided in the notice. If submitting by fax due to receiving a notice with a fax number, include a "Confidential" marked cover sheet. For those self-reporting without a specific notice from the FTB, mail the form to the Filing Compliance Bureau at the address listed or use the provided fax number for immediate reporting. Ensure your documents are well organized for a smooth submission process.

Learn More on Ftb 3552

What is the FTB 3552 form?

The FTB 3552 form, known as the Identity Theft Affidavit, is a document provided by the State of California’s Franchise Tax Board. This form allows individuals who are actual or potential victims of identity theft to notify the FTB, so their account can be updated to highlight questionable activity. It's a crucial step in safeguarding one’s financial and personal information against unauthorized use.

Who should use the FTB 3552 form?

This form should be used by anyone who believes they are a victim or a potential victim of identity theft and suspects that the incident might affect their tax account. This includes individuals who have noticed unauthorized transactions or experienced the loss or theft of personal identification documents.

What information is required when submitting the FTB 3552 form?

When completing the FTB 3552 form, you will need to provide the following information:

  • Your last name, first name, and middle initial.
  • Your current mailing address as well as the address on your last tax return, if different.
  • Your telephone number and the best times to reach you.
  • The last four digits of your Social Security Number or your complete Individual Taxpayer Identification Number.
  • Details about the tax year(s) impacted, the date the identity theft incident occurred, and the last tax year you filed for.
Additionally, a declaration under penalty of perjury is required to confirm the truthfulness of the provided information. Sign the form and include the date signed.

What documentation must accompany the FTB 3552 Form?

Along with the completed FTB 3552 form, you should submit a copy of at least one of the following documents to verify your identity:

  1. Passport
  2. Driver license or Department of Motor Vehicles identification card
  3. Social security card (if available)
If applicable, including a police report or an Internal Revenue Service letter of determination can provide additional support for your claim.

How do I submit the FTB 3552 form?

The completed FTB 3552 form and any accompanying documents can be submitted either by mail or fax. If you have received a notice from the FTB, return this form and a copy of the notice to the address contained in the notice. On the other hand, if you are self-reporting a potential risk and haven't received an FTB notice, mail or fax your documents to the addresses or numbers provided on the form. Remember, the FTB does not initiate contact with taxpayers via email, ensuring your sensitive information is handled securely.

What should I do if I haven't received a response after submitting the form?

If you haven't received a response or acknowledgment from the Franchise Tax Board after a reasonable period, it’s recommended to follow up. You can do this by calling the FTB directly at the numbers provided on the form. Make sure to have your submission details handy for reference during the call.

Where can I find additional resources on identity theft?

If you’re looking for more information or resources regarding identity theft, the Office of the Attorney General’s website at oag.ca.gov offers a comprehensive overview and additional steps you can take. Furthermore, for privacy information, the FTB’s official website, ftb.ca.gov, contains detailed privacy notices and guidelines for protecting your personal information.

Common mistakes

When people fill out the FTB 3552 form, it's crucial to ensure that all information is accurate and complete to avoid issues with the Franchise Tax Board. Here are six common mistakes to steer clear of:

  1. Not checking the correct status box to indicate whether they are a victim of identity theft or a potential victim. This mistake can lead to improper handling of their case.

  2. Failing to provide a detailed explanation of the tax impact, if applicable. This information helps the FTB understand the situation better and take appropriate actions.

  3. Omitting the tax year(s) impacted. Knowing which tax years are affected is crucial for the FTB to correctly update your account status.

  4. Leaving out the last four digits of their Social Security Number or their complete Individual Taxpayer Identification Number. This identifier is essential for verifying the individual’s account.

  5. Not signing the form or neglecting to provide the date the form was signed. A signature and date under the declaration are required to validate the affidavit.

  6. Forgetting to submit a copy of at least one document to verify their identity, such as a passport or driver's license. Proper identification is necessary for processing the form.

Avoiding these mistakes can significantly smooth the process of alerting the Franchise Tax Board to any questionable activity on your account due to identity theft.

Documents used along the form

When dealing with the complications of identity theft, especially in matters concerning taxes, it's crucial to have the right forms and documents lined up. The FTB 3552 form is a starting point for individuals to notify the Franchise Tax Board (FTB) about the incident and safeguard their accounts. However, this journey often requires more than just one form. Let's walk through some additional documents that tend to accompany the FTB 3552 form in these situations.

  • Police Report: A detailed report from the police is invaluable. It not only serves as a formal record of the identity theft but also is a key document that almost all financial institutions and authorities, including the FTB, may request to corroborate your claim.
  • IRS Form 14039 (Identity Theft Affidavit): If the identity theft has affected your federal taxes, submitting IRS Form 14039 will alert the IRS of the situation. This affidavit assists in preventing fraudulent tax returns from being filed in your name.
  • Credit Report Dispute Forms: When your identity is stolen, fraudulent information may appear on your credit report. Filing disputes with all three major credit bureaus—Equifax, TransUnion, and Experian—can help correct inaccuracies caused by identity theft. Each bureau provides a form for disputing credit report inaccuracies.
  • FTB Form 540 (California Resident Income Tax Return): If identity theft has implications on your filed taxes, amending past returns might be necessary. Form 540 is used for filing an amended return in California, correcting any information affected by the theft.
  • Proof of Identity Documents: In conjunction with the FTB 3552 form, providing additional proof of identity can strengthen your case. This includes copies of your social security card, birth certificate, or other government-issued identification.

Dealing with identity theft is undeniably stressful. Each document serves a purpose in the recovery process, helping to rebuild and protect your financial health and your identity. Navigating these procedures can be overwhelming, but arm yourself with knowledge, and you'll find a path through. Remember, safeguarding personal information is just as crucial in preventing further incidents as it is in resolving current ones.

Similar forms

The FTB 3552 form is a critical document for individuals dealing with identity theft, particularly in relation to their tax accounts. Other documents share similarities with it in terms of their purpose, the type of information they collect, and how they are utilized by various organizations. Here are eight documents similar to the FTB 3552 form:

  • Form 14039 (IRS Identity Theft Affidavit): Like the FTB 3552, this form is used to report identity theft to a tax authority, in this case, the Internal Revenue Service. It helps victims of identity theft protect their tax records and alerts the IRS to scrutinize tax returns filed under the victim's Social Security Number more carefully.
  • Identity Theft Report by the Federal Trade Commission (FTC): Although not used exclusively for tax-related identity theft, the FTC's Identity Theft Report helps victims of identity theft broadly, including securing credit reports and disputing fraudulent charges, which impacts tax account security indirectly.
  • Identity Theft Victim’s Complaint and Affidavit: This document is akin to the FTB 3552 as it serves a similar purpose of reporting identity theft but is more focused on the details of the fraud rather than the implications on tax accounts. It is widely accepted by financial institutions and creditors.
  • SSA-7008 (Request for Correction of Earnings Record): Provided by the Social Security Administration, this form is utilized when someone needs to correct their earnings record due to misreported earnings, which might be a consequence of identity theft. This can indirectly affect tax records and liabilities.
  • Change of Address Form (IRS Form 8822): Though primarily for updating address information with the IRS, this form can be crucial for individuals who have experienced identity theft as it ensures that they receive all IRS correspondences directly, mitigating the risk of fraudulent account activity unnoticed.
  • DMV Identity Theft Reporting Form: Specific to the Department of Motor Vehicles, this form focuses on identity theft related to driving records and licenses, which can also include tax implications if someone uses a stolen identity to obtain employment.
  • Credit Freeze Requests: While not a single form, requests to credit bureaus to freeze one’s credit can prevent further fraudulent activities. Like the FTB 3552, they are a defensive measure against the ramifications of identity theft on one's financial and tax status.
  • Police Report for Identity Theft: Filing a police report is a recommended step for victims of identity theft. It provides legal documentation of the crime and is often required by creditors and agencies, including the Franchise Tax Board, to proceed with an identity theft claim.

Each of these documents plays a vital role in safeguarding personal information and financial health, sharing the common goal with the FTB 3552 of mitigating the effects and risks associated with identity theft.

Dos and Don'ts

When you're filling out the FTB 3552 form, an identity theft affidavit with the Franchise Tax Board in California, it's paramount to ensure your information is accurate and submitted correctly. Here are some dos and don'ts to guide you through the process:

Do:
  • Review the form thoroughly before you start. Make sure you understand every section to provide accurate information.
  • Provide a concise explanation of the tax impact if you’ve been a victim. Whether you’re currently impacted or potentially at risk, clarity helps the FTB address your concerns appropriately.
  • Include the last 4 digits of your Social Security Number or your complete Individual Taxpayer Identification Number. This is crucial for verifying your identity.
  • Attach a copy of at least one form of identification as specified (e.g., passport, driver license), and if available, a social security card, police report, or IRS letter of determination, to support your claim.
  • Sign and date the form under penalty of perjury. Your signature attests to the truthfulness and accuracy of the provided information.
  • Follow the submission instructions carefully. Depending on your situation, you’ll need to mail or fax the form, along with the necessary documents.
Don't:
  • Leave relevant fields blank. If a section applies to you, ensure all required information is provided.
  • Guess on dates or figures. It’s better to verify the correct information to prevent any misunderstandings or processing delays.
  • Use a social security number or taxpayer identification number that isn’t yours. Misrepresentation can lead to severe consequences.
  • Submit without checking for errors. A quick review can catch and correct mistakes that might complicate your situation further.
  • Forget to include the required identification documents. These are essential for verifying your identity and processing your affidavit.
  • Ignore the correct submission method. Sending your form and documents to the wrong address or fax number can delay the process.

Misconceptions

Understanding the FTB 3552 form related to identity theft and the Franchise Tax Board (FTB) in California is crucial. However, there are several misconceptions surrounding how to use it correctly. Here are seven common myths and the truths behind them:

  • Only victims of identity theft need to file FTB 3552. While it is true that victims use this form to report incidents affecting their tax accounts, it is also intended for individuals who believe they may be at risk of identity theft, even if their financial information hasn’t been used fraudulently yet.
  • Submitting the FTB 3552 form is complicated. Some people think the process is filled with bureaucratic red tape. In truth, the form is straightforward and guides the filer through reporting the incident or potential risk, step by step.
  • Fax is the best way to submit the form. While faxing is an option, it's not necessarily the best for everyone. The form includes instructions for mailing, which may be preferable for those without fax access. Plus, it offers additional submission methods should a notice from the FTB have been received.
  • Any document is sufficient for identity verification. The form specifies acceptable documents such as a passport or driver’s license. Not every document will suffice. Ensuring the correct type of documentation is submitted is crucial for the process.
  • The FTB initiates contact via email or fax for follow-up. The FTB specifically states that it does not contact taxpayers through these channels to initiate inquiries. Communication is primarily conducted through mail or other secure methods to protect taxpayer information.
  • There’s no support available for non-English speakers. The form inquires about the primary language of the filer, indicating that the FTB provides support for speakers of languages other than English, including Spanish and others specified by the filer.
  • The form’s submission is an immediate resolution to identity theft. Filing the FTB 3552 is an important step in alerting the FTB to the situation, but it is part of a broader process of identity theft resolution that may involve other actions like filing a police report or contacting other financial institutions.

Clearing up these misconceptions ensures that individuals understand how to properly use the FTB 3552 form. It's a vital tool for managing and mitigating the impacts of identity theft on one's tax account, assisting both victims and those at potential risk in navigating through an understandably troubling time with more confidence and support.

Key takeaways

When dealing with the complexities of identity theft, it's crucial to take proactive steps to safeguard your tax account. The FTB 3552 form is a key tool for individuals in California who find themselves either victims or potential victims of this distressing circumstance. Here are several important takeaways regarding the completion and submission of this form.

  • Identify Your Status: The form provides options to indicate whether you are an actual victim of identity theft affecting your tax account, believe you may be at risk due to recent incidents, or are at risk due to situations like a lost or stolen purse. Make sure to check the appropriate box to accurately represent your situation.
  • Document Submission: Accompanying the completed form with verification documents is mandatory. Options include a passport, driver's license, social security card, police report, or an IRS letter of determination. This documentation helps the Franchise Tax Board (FTB) in accurately assessing and updating your account status.
  • Submission Details: You can submit the form alongside the required documents either by mail or fax, based on the information provided in the notice received from FTB or, if you haven't received a notice, using the details provided on the form for self-reporting situations.
  • Confidentiality: If faxing the documents, it is advised to include a cover sheet marked “Confidential” to ensure your sensitive information is handled securely.
  • Electronic Communication: It's important to note that the FTB does not initiate contact with taxpayers via email or fax for the submission of this form, which emphasizes the importance of following the specific submission instructions provided.
  • Assistance and Resources: For additional support, the FTB encourages individuals to connect through their website or phone service for further assistance. Moreover, they recommend visiting the Office of the Attorney General’s website for supplementary resources on dealing with identity theft.
  • Complete and Accurate Information: Signing the form under penalty of perjury requires that all provided information be true, complete, correct, and made in good faith. It's crucial to double-check all entered information to prevent any complications in processing your case.

Addressing identity theft is an undoubtedly stressful process. However, by carefully completing the FTB 3552 form and submitting the necessary supporting documents, individuals can take significant steps towards securing their financial and personal information and mitigating the future impact on their tax accounts.

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