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Blank IRS 14039 Form

The IRS 14039 form is a crucial document used by individuals to report suspected identity theft to the Internal Revenue Service. By submitting this form, taxpayers can take proactive steps to protect their financial information and ensure their tax records are secure. Understanding the process and implications of the IRS 14039 form can empower individuals to act swiftly in the face of identity theft concerns.

Outline

The IRS Form 14039, also known as the Identity Theft Affidavit, plays a crucial role in the fight against identity theft in the United States. When individuals suspect that their personal information has been compromised, this form serves as an essential tool for reporting such incidents to the IRS. By submitting Form 14039, taxpayers can alert the IRS to potential fraudulent activity linked to their Social Security number or tax filings. The form not only helps protect taxpayers but also initiates a process to resolve any issues arising from identity theft. It requires individuals to provide specific information, including details about the suspected theft and any fraudulent activity encountered. Understanding the purpose and proper use of this form is vital for anyone who believes they may have fallen victim to identity theft, ensuring that they take the necessary steps to safeguard their financial identity and rectify any tax-related problems that may arise as a result.

Sample - IRS 14039 Form

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)

Click for PDF

Form Information

Fact Name	Description
Purpose	The IRS Form 14039 is used to report identity theft related to tax issues.
Eligibility	Any individual who suspects that their identity has been used to file a tax return can submit this form.
Filing Method	The form can be submitted online or mailed to the IRS, depending on the situation.
Supporting Documents	Taxpayers may need to provide additional documentation to support their claim of identity theft.
Processing Time	It may take the IRS several weeks to process the form and resolve the identity theft issue.
State-Specific Forms	Some states may have their own forms for reporting identity theft, governed by state laws.
IRS Response	Upon receiving Form 14039, the IRS will issue a notice to confirm receipt and may follow up with additional questions.
Protection Measures	Filing this form can help protect taxpayers from further fraudulent activity on their accounts.
Confidentiality	The information provided on Form 14039 is kept confidential to protect the taxpayer's identity.
Resources	The IRS provides resources and guidance on its website for individuals dealing with identity theft.

Detailed Guide for Filling Out IRS 14039

After you have gathered the necessary information, you can proceed to fill out the IRS 14039 form. Follow these steps carefully to ensure that all required sections are completed accurately.

Download the IRS 14039 form from the official IRS website or obtain a physical copy.
Begin by entering your personal information at the top of the form. This includes your name, address, and Social Security number.
Provide your date of birth in the specified format.
Indicate whether you are a victim of identity theft by checking the appropriate box.
Complete the section regarding your tax return. Specify the tax year in question.
If applicable, include any additional information that may assist the IRS in processing your claim.
Review all entries for accuracy and completeness.
Sign and date the form at the bottom.
Make a copy of the completed form for your records.
Submit the form according to the instructions provided, either by mail or electronically, as appropriate.

Obtain Answers on 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 who believe they are victims of identity theft. This form allows taxpayers to report that their personal information has been misused, particularly in relation to tax filings. It helps the IRS take necessary actions to protect the taxpayer's account and rectify any fraudulent activity.
Who should use Form 14039?

Individuals who suspect that their personal information has been stolen and used to file fraudulent tax returns should complete this form. Common scenarios include receiving a notice from the IRS about a tax return filed in your name that you did not submit or discovering that your Social Security number has been used without your consent.
How do I complete Form 14039?

To complete Form 14039, you will need to provide your personal information, including your name, address, Social Security number, and details about the identity theft incident. The form requires you to explain how you became aware of the identity theft and what steps you have already taken, such as contacting the credit bureaus or filing a police report.
Where do I send Form 14039?

After filling out Form 14039, you should send it to the address specified in the instructions on the form. Typically, this will be the IRS office that handles identity theft cases. Ensure that you keep a copy of the form for your records.
What happens after I submit Form 14039?

Once the IRS receives your Form 14039, they will review your case. You may receive a confirmation from the IRS acknowledging receipt of your affidavit. The IRS will investigate the reported identity theft and take appropriate actions, which may include marking your account to prevent further fraudulent activity.
Can I file Form 14039 electronically?

No, Form 14039 cannot be filed electronically. It must be printed, completed, and mailed to the IRS. This requirement ensures that the IRS can properly handle sensitive information related to identity theft.
What if I find additional fraudulent activity after submitting Form 14039?

If you discover more instances of identity theft after submitting the form, it is advisable to report these new findings to the IRS as well. You may need to submit another Form 14039 or provide additional documentation to support your claims. Keeping the IRS informed will help them protect your account more effectively.
Is there a deadline for submitting Form 14039?

While there is no specific deadline for submitting Form 14039, it is crucial to act promptly if you suspect identity theft. The sooner you report the incident, the better chance you have of mitigating any potential damage and resolving issues with the IRS.
Are there any resources for assistance with Form 14039?

Yes, the IRS provides resources on its website, including instructions for completing Form 14039 and guidance on identity theft. Additionally, local taxpayer advocate offices can offer assistance. It may also be beneficial to consult with a tax professional or legal advisor if you have complex issues related to identity theft.

Common mistakes

Filling out the IRS Form 14039, also known as the Identity Theft Affidavit, can be a daunting task. Many individuals make common mistakes that can delay the processing of their claims or lead to further complications. One frequent error is failing to provide accurate personal information. It is essential to ensure that your name, address, and Social Security number are correct. A simple typo can result in the IRS being unable to match your affidavit with your tax records.

Another mistake often made is neglecting to sign the form. The IRS requires a signature to validate the affidavit. Without it, the form may be considered incomplete. Remember, your signature is not just a formality; it confirms that the information you provided is true to the best of your knowledge.

People also tend to overlook the importance of including all relevant documentation. Supporting documents can help substantiate your claim of identity theft. If you fail to attach these documents, the IRS may require additional information, prolonging the resolution of your case.

Additionally, some individuals submit the form without checking the filing instructions. Each year, the IRS may update its guidelines. Ignoring these updates can lead to using outdated forms or incorrect submission methods, which can complicate the process.

Lastly, many forget to keep a copy of the completed form for their records. Keeping a personal copy is vital for tracking your claim and for any future correspondence with the IRS. By avoiding these common mistakes, you can help ensure a smoother process when filing your IRS Form 14039.

Documents used along the form

The IRS Form 14039, known as the Identity Theft Affidavit, is an important document for individuals who suspect they have been victims of identity theft. When filing this form, there are several other documents that may be required or helpful in addressing the issues related to identity theft. Below is a list of these additional forms and documents, each accompanied by a brief description.

IRS Form 1040: This is the standard individual income tax return form. It may need to be filed if your identity theft has affected your tax filings.
IRS Form 8821: This form allows you to authorize someone to receive your tax information. You might need this if you’re working with a tax professional to resolve identity theft issues.
IRS Form 14039-B: This is the supplemental identity theft affidavit that may be used in certain cases where additional information is required.
Credit Reports: Obtaining your credit reports from the major credit bureaus can help identify unauthorized accounts opened in your name, which is crucial in resolving identity theft.
Fraud Alerts: Placing a fraud alert on your credit report can help protect you from further identity theft. This document notifies creditors to take extra steps to verify your identity before extending credit.
Identity Theft Report: This report is filed with the Federal Trade Commission (FTC) and serves as an official record of the identity theft incident, which can be useful for disputing fraudulent charges.
Police Report: Filing a report with your local law enforcement can provide additional documentation to support your case of identity theft.
Form W-2 or 1099: These forms report your earnings and may be necessary to show the IRS any discrepancies related to your income due to identity theft.
Identity Theft Recovery Plan: A personal plan outlining steps to take after identity theft can help you stay organized and focused on resolving the issues.

By understanding these additional documents and forms, individuals can better navigate the complexities of identity theft and work towards reclaiming their identity and financial security. It is essential to act swiftly and keep thorough records throughout the process.

Similar forms

The IRS Form 14039, also known as the Identity Theft Affidavit, is used by individuals to report identity theft related to their tax records. Several other documents serve similar purposes in terms of reporting identity theft or related issues. Here’s a list of five such documents:

FTC Identity Theft Complaint Form: This form is used to report identity theft to the Federal Trade Commission (FTC). Like the IRS 14039, it helps victims document their experience and provides a record for further actions.
Credit Freeze Request Form: Individuals can use this form to request a freeze on their credit reports. This action prevents new creditors from accessing the report, similar to how the IRS 14039 protects a taxpayer's identity from fraudulent tax filings.
Fraud Alert Request: This request can be made to credit bureaus to alert them of potential identity theft. It functions like the IRS 14039 by notifying relevant parties of a possible identity theft situation.
Identity Theft Report: When filing a police report about identity theft, individuals create an official record. This report serves a similar purpose to the IRS 14039 in documenting the incident and can be used to support claims with creditors.
IRS Form 14039-B: This form is a variation of the IRS 14039 specifically for businesses. It helps business owners report identity theft, paralleling the individual-focused IRS 14039 in its aim to address and resolve identity theft issues.

Dos and Don'ts

When filling out the IRS Form 14039, which is used to report identity theft, it's essential to follow certain guidelines to ensure your submission is accurate and effective. Here are four important dos and don'ts to keep in mind:

Do provide accurate personal information. Make sure your name, address, and Social Security number are correct.
Do explain your situation clearly. Include details about how you became aware of the identity theft.
Don't leave any sections blank. Fill out all required fields to avoid delays in processing.
Don't forget to sign and date the form. An unsigned form may lead to rejection or additional questions.

Misconceptions

The IRS Form 14039, also known as the Identity Theft Affidavit, is an important document for individuals who suspect that their personal information has been compromised. However, there are several misconceptions surrounding this form that can lead to confusion. Below are ten common misconceptions explained for clarity.

Only victims of identity theft can file Form 14039.
This is not entirely true. While the form is primarily for those who have been victims, anyone who suspects their information may have been misused can file it to protect themselves.
Filing Form 14039 guarantees the IRS will resolve the issue immediately.
The process can take time. Filing the form is a crucial step, but resolution may depend on various factors, including the complexity of the case.
You must file Form 14039 every year.
This is a misconception. You only need to file it if you suspect identity theft or have been a victim. There is no annual requirement.
Form 14039 can only be filed online.
You can submit Form 14039 by mail as well. The IRS provides options for both online and paper submissions.
Filing Form 14039 will automatically freeze your credit.
This is incorrect. Form 14039 does not freeze your credit. You must contact credit bureaus separately to place a freeze on your credit report.
Once filed, you cannot take further action.
This is false. Filing the form does not limit your options. You can still take additional steps to protect your identity and finances.
The form is only for tax-related identity theft.
While it is commonly used for tax issues, it can also be relevant for other types of identity theft that affect your financial standing.
You need an attorney to file Form 14039.
This is not necessary. Individuals can file the form on their own without legal representation.
Filing Form 14039 will affect your tax refund.
This misconception can cause concern. Filing the form does not inherently delay or reduce your tax refund; it is a protective measure.
All identity theft cases require Form 14039.
This is not accurate. Some cases may not require filing this form, especially if there is no impact on your tax records.

Understanding these misconceptions can help you navigate the process more effectively. If you believe your identity has been compromised, consider taking action promptly to safeguard your personal information.

Key takeaways

When dealing with the IRS 14039 form, it’s important to understand its purpose and how to fill it out correctly. Here are some key takeaways to keep in mind:

The IRS 14039 form is used to report identity theft related to your tax return.
Fill out the form completely to ensure the IRS can process your request efficiently.
Provide as much detail as possible about the identity theft incident.
Attach any supporting documents that can help verify your claim.
Submit the form as soon as you suspect identity theft to minimize potential damage.
Keep a copy of the completed form for your records.
Follow up with the IRS if you do not receive confirmation of your submission.
Consider contacting the Federal Trade Commission (FTC) for additional support and resources.

Using the IRS 14039 form correctly can help protect your financial identity and ensure that your tax matters are handled properly.