Blank IRS 14039 Template

The IRS Form 14039 is a tool designed to help individuals report identity theft related to their tax returns. This form allows taxpayers to inform the IRS that their personal information may have been compromised, ensuring that necessary steps are taken to protect their tax records. If you believe you're a victim of identity theft, it’s crucial to fill out this form—click the button below to get started.

Article Structure

The IRS 14039 form, known as the Identity Theft Affidavit, plays a crucial role in protecting taxpayers from the growing threat of identity theft. When individuals suspect that someone has fraudulently used their Social Security number or other personal information to file a tax return, this form serves as an essential tool for reporting the issue. Completing the IRS 14039 allows taxpayers to inform the IRS of the identity theft, enabling them to take necessary actions to secure the taxpayer's account and rectify any fraudulent activity. This form not only initiates the process for resolving tax-related identity theft but also helps in preventing further misuse of personal information. It is vital for individuals to understand the steps involved in filling out the form accurately, as well as the importance of submitting it promptly to mitigate any potential financial repercussions. By addressing identity theft swiftly, taxpayers can regain control over their financial information and work towards a resolution with the IRS.

Form Sample

Form 14039

(May 2024)

Department of the Treasury - Internal Revenue Service

Identity Theft Affidavit

OMB Number

1545-2139

This affidavit is for victims of identity theft. To avoid delays do not use this form if you have already filed a Form 14039 for this incident.

Form 14039 can also be completed online at https://www.irs.gov/dmaf/form/f14039.

The IRS process for assisting victims selecting Section B, Box 1 below is explained at irs.gov/victimassistance.

Get an IP PIN: We encourage everyone to opt-in to the Identity Protection Personal Identification Number (IP PIN) program. If you don’t have an IP PIN, you can get one by going to irs.gov/ippin. If unable to do so online, you may schedule an appointment at your closest Taxpayer Assistance Center by calling (844-545-5640). Or, if eligible, you may use IRS Form 15227 to apply for an IP PIN by mail or FAX, also available by going to irs.gov/ippin.

Section A - Check the following boxes in this section that apply to the specific situation you are reporting (required for all filers)

1. I am submitting this Form 14039 for myself

2. I am submitting this Form 14039 in response to an IRS Notice or Letter received

•Provide ‘Notice’ or ‘Letter’ number(s) on the line to the right

•Check box 1 in Section B and see special mailing and faxing instructions on reverse side of this form.

3. I am submitting this Form 14039 on behalf of my dependent child or dependent relative (include that person’s information below in Section C and D)

•Complete Sections A-F of this form. Do not use this form If dependent’s identity was misused by a parent or guardian in filing taxes, this is not identity theft.

4. I am submitting this Form 14039 on behalf of another person living or deceased (other than my dependent child or dependent relative)

• Complete Sections A- F of this form.

Section B – How I Am Impacted (required when reporting misuse of Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN))

Check all boxes that apply to the person listed in Section C below. If the person in Section C has previously submitted a Form 14039 for the same incident, there’s no need to submit another Form 14039.

1. I know or suspect that someone used my information to fraudulently file a federal tax return

I/My dependent was fraudulently/incorrectly claimed as a dependent (use that person’s information for Section C & D)

My SSN or ITIN was fraudulently used for employment purposes

Note: If you are a victim of Identity theft but it does not involve your federal tax return, you should request an IP PIN to protect yourself. Get An Identity Protection PIN | Internal Revenue Service (irs.gov)

Provide an explanation of the identity theft issue, how it impacts your tax account, when you became aware of it and provide relevant dates. If needed, attach additional information and/or pages to this form

Section C – Name and Contact Information of Identity Theft Victim (required)

Victim’s last name

First name

Middle

Taxpayer Identification Number

initial

(provide 9-digit SSN or ITIN)

Current mailing address (apartment or suite

number and street, or P.O. Box)

Current city

State

ZIP code

If deceased, provide last known address

Address used on last filed tax return (if different than ‘Current’)

City (on last tax return filed)

State

ZIP code

Telephone number with area code. The IRS may call you regarding this affidavit

Best time(s) to call

Home phone number

Cell phone number

Language in which you would like to be contacted

English

Spanish

Other

Section D – Tax Account Information: Last tax return filed (year shown on the tax return) and Returns Impacted

I was not required to file a return or filed a return with no income information

Names used on last filed tax return

The last tax return filed (year shown on the tax return)

What Tax Year(s) you believe were impacted by tax-related identity theft (example: 2020 is input for citing the 2020 tax return though filed the next year(s). (if not known, enter ‘Unknown’ below))

Submit this completed form to either the mailing address or the FAX number provided on the reverse side of this form.

Catalog Number 52525A

www.irs.gov

Form 14039 (Rev. 5-2024)

Section E – Penalty of Perjury Statement and Signature (required)

Under penalty of perjury, I declare that, to the best of my knowledge and belief, the information entered on this Form 14039 is true, correct, complete, and made in good faith.

Signature of taxpayer, or representative, conservator, parent or guardian

Date signed

Section F – Representative, Conservator, Parent or Guardian Information (required if completing Form 14039 on someone else’s behalf)

Check only ONE of the following five boxes next to the reason you are submitting this form

1.The taxpayer is deceased, and I am the surviving spouse

•No attachments are required, including death certificate.

2.The taxpayer is deceased, and I am the court-appointed or certified personal representative

•Attach a copy of the court certificate showing your appointment.

3.The taxpayer is deceased, and a court-appointed or certified personal representative has not been appointed

•Attach copy of death certificate or formal notification from a government office informing next of kin of the decedent’s death.

• Indicate your relationship to decedent:

Child

Parent/Legal Guardian

Other

4. The taxpayer is unable to complete this form and I am the appointed conservator, or I have been authorized to act on behalf of the taxpayer per Form 2848, Power of Attorney and Declaration of Representative

•Attach a copy of documentation showing your appointment as conservator or Power of Attorney authorization.

•If you have an IRS issued Centralized Authorization File (CAF) number, enter the nine-digit number:

5. The person listed above is my dependent child or my dependent relative

By checking this box and signing below you are indicating that you are an authorized representative, as parent, guardian or legal guardian, to file a legal document on the dependent’s behalf.

• Indicate your relationship to person	Parent/Legal Guardian	Power of Attorney
Fiduciary per IRS Form 56, Notice of Fiduciary Relationship		Other

Parent’s/Representative's name
Last name	First name		Middle initial

Parent’s/Representative’s current mailing address (city, town or post office, state, and ZIP code)

Parent’s/Representative’s telephone number

Instructions for Submitting this Form

Submit this completed and signed form to the IRS via Online, Mail or FAX to specialized IRS processing areas dedicated to assist you. In Section C of this form, be sure to include the Social Security Number in the ‘Taxpayer Identification Number’ field.

Help us avoid delays:

•Do not use this form if you have already filed a Form 14039 for this incident.

•Choose one method of submitting this form either Online (preferred method), by Mail, or by FAX, not all methods.

•Provide clear and readable photocopies/images of any additional information you may choose to provide.

•Submit the original tax return to the IRS location where you normally file your tax return. Do not use the following address or fax number to file an original tax return.

	Online (Preferred Method)		Submitting by Mail
• https://www.irs.gov/dmaf/form/f14039		•	If you checked Box 2 in Section A in response to a notice or letter
			received from the IRS, return this form and if possible, a copy of the
	Submitting by FAX
	Submitting by FAX		notice or letter to the address contained in the notice or letter.
• Always include a cover sheet marked "Confidential”.		•	If you checked Box 1 or 2 in Section B of Form 14039 and are unable
• If you checked Box 2 in Section A of Form 14039 and are submitting			to file your tax return electronically because the SSN/ITIN of you,
	this form in response to a notice or letter received from the IRS. If it		your spouse, or dependent was misused, attach this Form 14039 to
	provides a FAX number, you should send there.		the back of your paper tax return and submit to the IRS location where
•	If no FAX number is shown on the notice or letter, follow the mailing		you normally file your tax return.
•		•	All others should mail this form to:
	instructions on the notice or letter.	•	All others should mail this form to:
•	For all others, FAX this form toll-free to:		Department of the Treasury
•	For all others, FAX this form toll-free to:		Internal Revenue Service
	855-807-5720		Internal Revenue Service
	855-807-5720		Fresno, CA 93888-0025
			Fresno, CA 93888-0025

	Privacy Act and Paperwork Reduction Notice

Our legal authority to request the information is 26 U.S.C. 6001. The primary purpose of the form is to provide a method of reporting identity theft issues to the IRS so that the IRS may document situations where individuals are or may be victims of identity theft. Additional purposes include the use in the determination of proper tax liability and to relieve taxpayer burden. The information may be disclosed only as provided by 26 U.S.C. 6103. Providing the information on this form is voluntary. However, if you do not provide the information it may be more difficult to assist you in resolving your identity theft issue. If you are a potential victim of identity theft and do not provide the required substantiation information, we may not be able to place a marker on your account to assist with future protection. If you are a victim of identity theft and do not provide the required information, it may be difficult for IRS to determine your correct tax liability. If you intentionally provide false information, you may be subject to criminal penalties. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send this form to this address. Instead, see the form for filing instructions. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

Catalog Number 52525A

www.irs.gov

Form 14039 (Rev. 5-2024)

⇩ PDF

Document Specifications

Fact Name	Description
Purpose	The IRS Form 14039 is used to report suspected identity theft related to tax returns.
Eligibility	Any taxpayer who believes their personal information has been compromised can file this form.
Submission Method	The form can be submitted electronically or mailed to the IRS, depending on the situation.
State-Specific Forms	Some states have their own forms for reporting identity theft, governed by state laws such as California Civil Code Section 1798.92.
Processing Time	After submission, the IRS typically takes several weeks to process the form and respond to the taxpayer.
Follow-Up Actions	Taxpayers may need to take additional steps, such as placing a fraud alert on their credit reports, after filing this form.

Steps to Filling Out IRS 14039

Once you have gathered the necessary information, you can begin filling out the IRS Form 14039. This form is used for reporting identity theft related to your tax records. After completing the form, you will need to submit it to the IRS along with any required documentation.

Begin by downloading the IRS Form 14039 from the official IRS website or obtaining a physical copy from a local IRS office.
At the top of the form, fill in your name as it appears on your tax return.
Provide your Social Security number (SSN) or Individual Taxpayer Identification Number (ITIN) in the designated space.
Enter your address, including street, city, state, and ZIP code.
In the section labeled "Check all that apply," mark the boxes that describe your situation regarding identity theft.
In the comments section, briefly explain your situation. Include any relevant details that can help the IRS understand your case.
Sign and date the form at the bottom. This confirms that the information you provided is accurate to the best of your knowledge.
Make a copy of the completed form for your records before submitting it.
Submit the form according to the instructions provided, either by mail or electronically, as appropriate.

More About IRS 14039

What is the IRS Form 14039?

The IRS Form 14039, also known as the Identity Theft Affidavit, is a document used by individuals to report suspected identity theft related to their tax records. This form helps the IRS track and address cases of identity theft that affect taxpayers and their filings.

When should I use Form 14039?

You should use Form 14039 if you believe your personal information has been stolen and used to file a fraudulent tax return. Additionally, if you receive a notice from the IRS indicating that multiple tax returns have been filed using your Social Security number, this form is necessary.

How do I fill out Form 14039?

To complete Form 14039, provide your personal information, including your name, address, and Social Security number. Then, explain the circumstances of the identity theft in detail. Be sure to sign and date the form before submission to ensure it is valid.

Where do I send Form 14039?

After filling out Form 14039, send it to the address specified in the instructions on the form. Typically, this will be the IRS office handling identity theft cases. Make sure to keep a copy for your records.

What happens after I submit Form 14039?

Once the IRS receives your Form 14039, they will review the information provided. They may contact you for additional details or documentation. The IRS will also take steps to protect your tax account from further fraudulent activity.

Can I submit Form 14039 electronically?

Currently, Form 14039 must be submitted via mail. The IRS does not offer an electronic submission option for this specific form. Ensure that you send it to the correct address to avoid delays.

Will submitting Form 14039 delay my tax refund?

Yes, submitting Form 14039 can delay your tax refund. The IRS needs time to investigate the identity theft claim, which may extend the processing time for your tax return and any associated refunds.

How can I protect myself from identity theft in the future?

To protect yourself from future identity theft, consider taking proactive measures such as using strong, unique passwords for your accounts, regularly monitoring your credit report, and placing a fraud alert on your credit file. Additionally, be cautious about sharing personal information online.

What if I need help with Form 14039?

If you need assistance with completing Form 14039, you can reach out to a tax professional or contact the IRS directly for guidance. They can provide you with the necessary support to ensure that your form is filled out correctly.

Is there a deadline for submitting Form 14039?

There is no specific deadline for submitting Form 14039, but it is advisable to file it as soon as you suspect identity theft. Prompt reporting can help the IRS take quicker action to protect your tax account and prevent further fraudulent activity.

Common mistakes

Filling out the IRS Form 14039, which is used to report identity theft, can be a daunting task. Many individuals make common mistakes that can delay the process or even lead to further complications. Below is a list of nine mistakes to avoid when completing this important form:

Not providing complete information:
Many people forget to fill in all required fields. Ensure that every section is completed, including your name, address, and Social Security number.
Using incorrect identification:
Some individuals mistakenly use the wrong identification number. Always use your Social Security number or Individual Taxpayer Identification Number (ITIN) as required.
Failing to sign the form:
A signature is crucial. Without it, the form may be considered invalid, and your report may not be processed.
Not including supporting documentation:
People often neglect to attach necessary documents that support their claim of identity theft. Include any relevant information to strengthen your case.
Submitting the form to the wrong address:
Make sure you send the form to the correct address as specified in the instructions. Sending it to the wrong location can cause delays.
Ignoring deadlines:
Some individuals miss the deadline for reporting identity theft. Keep track of important dates to ensure timely submission.
Not keeping copies:
Failing to keep a copy of the completed form and any attached documents can lead to problems later. Always retain a copy for your records.
Not following up:
After submission, it’s important to follow up with the IRS. Many people assume everything is fine without confirming the status of their report.
Overlooking updates:
Changes in your situation or additional incidents of identity theft should be reported. Keeping the IRS informed is crucial for protecting your identity.

By avoiding these common mistakes, you can help ensure that your Form 14039 is processed smoothly and efficiently. Take your time, double-check your entries, and don’t hesitate to seek assistance if needed.

Documents used along the form

The IRS Form 14039, also known as the Identity Theft Affidavit, is a crucial document for individuals who suspect they have been victims of identity theft. When filing this form, there are other documents that may also be necessary to support your claim and protect your financial interests. Below is a list of commonly used forms and documents that can accompany the IRS 14039.

IRS Form 4506-T: This form allows individuals to request a transcript of their tax return. It can be helpful to verify income and tax information when dealing with identity theft issues.
IRS Form 14039-E: This is a supplementary form that provides additional information regarding the identity theft incident. It may be required in certain cases to clarify details related to the fraudulent activity.
Form 1040: Your personal income tax return may be needed to demonstrate discrepancies in your reported income or to provide a complete financial picture when addressing identity theft.
Police Report: A report from local law enforcement can serve as official documentation of the crime. This may be requested by the IRS or other institutions to substantiate your claims of identity theft.

Gathering these documents can streamline the process of addressing identity theft and help ensure that your case is handled efficiently. Taking prompt action is essential in protecting your identity and financial well-being.

Similar forms

The IRS Form 14039, known as the Identity Theft Affidavit, is designed for individuals who suspect that their personal information has been compromised and used fraudulently. This form serves as a formal declaration to the IRS, initiating the process to address the impact of identity theft on one’s tax filings. Similar in purpose to the IRS Form 14039, the Federal Trade Commission (FTC) Identity Theft Complaint form allows individuals to report identity theft incidents. Both documents aim to help victims document their experiences and take steps toward recovery, although the FTC form is broader in scope and can address various types of identity theft beyond tax-related issues.

Another document that shares similarities with the IRS Form 14039 is the IRS Form 8822, Change of Address. While Form 14039 focuses on reporting identity theft, Form 8822 is used to update the IRS with a new mailing address. Both forms are critical in ensuring that the IRS has accurate information on file. If someone has been a victim of identity theft, they may need to change their address to prevent further fraudulent activities and ensure that important tax documents reach them securely.

The IRS Form 4506-T, Request for Transcript of Tax Return, also parallels the IRS Form 14039 in that it allows taxpayers to obtain records of their tax filings. In cases of identity theft, victims may need to access their tax transcripts to verify what the IRS has on file. This can be crucial for resolving discrepancies and proving that fraudulent claims were made in their name. Both forms serve as tools for individuals to manage their tax records in light of identity theft.

Similar to the IRS Form 14039 is the IRS Form 1040-X, Amended U.S. Individual Income Tax Return. When identity theft occurs, it may necessitate corrections to previously filed tax returns. The 1040-X allows taxpayers to amend their returns to reflect accurate information. Both forms are essential for individuals seeking to rectify issues stemming from identity theft, ensuring that their tax records are accurate and up to date.

The Identity Theft Report provided by local law enforcement is another document that bears resemblance to the IRS Form 14039. When individuals report identity theft to the police, they receive an official report that can be used to support claims of fraud. This report can be submitted alongside the IRS Form 14039 to bolster the case with the IRS. Both documents serve as formal declarations of identity theft and are vital for taking further action against the perpetrators.

Lastly, the Social Security Administration’s (SSA) Form SS-5, Application for a Social Security Card, can be considered similar to the IRS Form 14039. In cases of identity theft, individuals may need to apply for a new Social Security number to prevent further misuse of their identity. While the IRS Form 14039 addresses tax-related identity theft specifically, the SS-5 form is crucial for securing one’s social security identity, which is often a key target for identity thieves. Both forms are integral in the recovery process for victims of identity theft.

Dos and Don'ts

When filling out the IRS Form 14039, it's essential to approach the process with care. This form is used to report identity theft and request a victim's identity theft affidavit. Here are some important dos and don'ts to keep in mind:

Do ensure that all personal information is accurate and up to date.
Do provide a clear description of the identity theft incident.
Do include any supporting documentation that can validate your claim.
Do keep a copy of the completed form for your records.

Don't leave any sections of the form blank; fill out all required fields.
Don't submit the form without checking for errors or omissions.
Don't forget to sign and date the form before submission.
Don't use a pencil; always fill out the form in ink to ensure clarity.

Following these guidelines can help ensure that your submission is processed smoothly and efficiently.

Misconceptions

The IRS Form 14039, also known as the Identity Theft Affidavit, is an important document for individuals who believe they have been victims of identity theft. However, several misconceptions surround this form. Here are nine common misunderstandings:

Only victims of tax-related identity theft can use this form.
While the form is primarily designed for tax-related identity theft, it can also be used by individuals who have experienced identity theft in other contexts, especially if it impacts their tax filings.
Filing Form 14039 guarantees a resolution.
Submitting the form does not automatically resolve identity theft issues. The IRS will review the information, but additional steps may be necessary for complete resolution.
You must file the form every year.
Form 14039 is only needed if you believe you have been a victim of identity theft affecting your tax return. If you haven’t experienced any new incidents, you don’t need to file it annually.
Form 14039 can only be submitted by mail.
While mailing is one option, the form can also be submitted electronically in certain situations, making it more convenient for some taxpayers.
Filing this form will prevent all future identity theft.
While it helps alert the IRS to potential issues, it does not provide complete protection against future identity theft. Ongoing vigilance is necessary.
Only individuals can file Form 14039.
Businesses can also file this form if they suspect identity theft has affected their tax filings. The process is similar for both individuals and businesses.
There is a fee to file Form 14039.
There is no cost associated with filing this form. It is a free resource provided by the IRS to help victims of identity theft.
Once the form is filed, the IRS will contact you immediately.
The IRS may take time to review the information and investigate. It's important to be patient as they work through the case.
Filing the form will automatically freeze your credit.
Form 14039 does not freeze your credit. To protect your credit, you need to contact credit bureaus separately to place a fraud alert or a credit freeze.

Understanding these misconceptions can help individuals navigate the process of reporting identity theft more effectively. If you believe you are a victim, taking the right steps is crucial for protecting your financial well-being.

Key takeaways

The IRS Form 14039, also known as the Identity Theft Affidavit, is a crucial document for individuals who believe they are victims of identity theft. Here are some key takeaways regarding its use and completion:

Purpose of the Form: The form is designed to report identity theft and to alert the IRS that someone may have used your personal information fraudulently.
Who Should File: If you receive a notice from the IRS indicating that more than one tax return has been filed in your name, you should consider filing Form 14039.
Gathering Information: Before filling out the form, collect all relevant information, including any correspondence from the IRS and details about the fraudulent activity.
Filling Out the Form: Complete all sections of the form accurately. Provide your personal information and describe the identity theft incident as clearly as possible.
Submitting the Form: You can submit Form 14039 by mailing it to the address specified in the instructions or by faxing it if applicable. Ensure you keep a copy for your records.
Follow Up: After submission, monitor your tax account and any correspondence from the IRS. It may take time for the IRS to process your claim.
Protecting Your Identity: Consider taking additional steps to protect your identity, such as placing a fraud alert on your credit report or freezing your credit.
Seek Professional Help: If you're unsure about the process or need assistance, consult a tax professional or an attorney who specializes in identity theft issues.

By understanding these key points, you can navigate the process of addressing identity theft with greater confidence and clarity.