South Roxana, IL · Madison County
Identity Theft Affidavit and Report
The South Roxana Police Department identity theft report is for victims to document suspected fraud and provide details and supporting records to the department.
What this form is
Use this form to report identity theft to the South Roxana Police Department. It asks for your contact information, details about the theft and any known suspect, and a summary of the events. Include related records in your possession; you may attach additional pages. The form also lets you choose how to receive a copy of the completed affidavit.
Who needs it
People reporting identity theft to the South Roxana Police Department can use this form to describe the incident and provide supporting records.
How to submit it
Provide the completed report to the responding officer or mail it to the South Roxana Police Department, 211 Sinclair Ave., South Roxana, IL 62087.
About notarization
This report is signed and dated without a notary; some creditors may require notarization, so check with each company before sending it to them.
How to submit this form
- 1
Download the Report
Download the South Roxana Police Department Identity Theft Affidavit and Report.
- 2
Complete the Form
Fill in your contact information, theft details, any known suspect information, and a detailed summary of the events.
- 3
Gather Supporting Records
Attach related records in your possession. Add further details on extra pages if needed.
- 4
Submit to the Police Department
Give the completed report to the responding officer or mail it to the South Roxana Police Department at the address on the form.
Frequently asked questions
- What is the Identity Theft Affidavit and Report?
- It is a South Roxana Police Department form for reporting identity theft. It collects your details, information about the theft and any known suspect, and a summary of the events.
- Who should use this identity theft report?
- People reporting identity theft to the South Roxana Police Department can complete the report and attach related records they have.
- Do I need a notary for the Identity Theft Affidavit and Report?
- No, the report is signed and dated without a notary. Some creditors may require notarization, so check with each company before sending it to them.
- How do I submit the Identity Theft Affidavit and Report?
- Provide the completed report to the responding officer or mail it to the South Roxana Police Department at 211 Sinclair Ave., South Roxana, IL 62087.