Identity Theft/Misuse Claim Form (US)

In order to prepare the Identity Theft/Misuse Claim Form so that you can download and print it with the bar code needed for us to process it, please fill out the form below and click Print Claim Form. This is a large file and might take a few minutes.

Once your personalized Identity Theft/Misuse Claim Form has been generated and you have printed it out, you must mail the completed form to the address listed on the printed Identity Theft/Misuse Claim Form.

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Contact Information

(For your convenience, this information will be automatically included on your printed claim form)