SSN Misuse Report Letter Template
[Your Full Name]
[Your Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]
Date: [Date]
To: [Company / Agency / Employer / Bank / Other Recipient Name]
[Department or Contact Name, if known]
[Address]
[City, State, ZIP Code]
Subject: Report of Unauthorized Use of Social Security Number
Dear [Recipient Name or Sir/Madam],
I am writing regarding the following account, file, application, claim, or record:
Account / Claim / Reference Number: [Number]
Name on Record: [Full Name]
Date of Birth or Other Identifier, if needed: [Identifier]
2. Notice of Unauthorized Use
I believe that my Social Security number may have been used without my knowledge or authorization.
I did not approve or authorize the use described below.
3. Description of the Issue
The unauthorized activity or suspected misuse involves the following:
[Describe the account, filing, application, employment record, notice, or other issue]
Date discovered: [Date]
If known, the issue involves:
☐ incorrect account activity
☐ unauthorized employment use
☐ tax-related misuse
☐ benefit-related misuse
☐ application or credit issue
☐ incorrect address or contact information
☐ other: [Describe]
The following information, activity, or record appears to be incorrect, unauthorized, or fraudulent:
[Describe the incorrect record, transaction, filing, address, employer, or other misuse]
If additional details are known, include them here:
[Insert details]
5. Request for Investigation and Correction
I respectfully request that you:
review the matter immediately;
investigate any unauthorized use of my Social Security number connected to your records;
correct any inaccurate or fraudulent information;
place any appropriate security alert, note, or restriction on the account or file;
confirm in writing what action has been taken.
If additional identity verification is required, please let me know.
I am including or can provide the following supporting documents, if needed:
☐ copy of identification
☐ account statement or notice
☐ proof of address
☐ fraud report or complaint reference
☐ correspondence related to the issue
☐ other: [Describe]
Please contact me regarding this matter at:
[Your Full Name]
[Phone Number]
[Email Address]
[Mailing Address]
8. Additional Security Request
Because this matter may involve identity misuse, I also request that you consider the following, if appropriate:
☐ fraud alert or internal account flag
☐ added verification before future account changes
☐ restriction on online changes
☐ review of recent activity
☐ other: [Describe]
Additional comments:
9. Closing
Thank you for your prompt attention to this matter. I request that this issue be reviewed and corrected as soon as possible and that I be notified of the outcome in writing.
10. Signature
Sincerely,
Signature: __________________________
Name: [Your Full Name]
Date: [Date]