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- Click ‘Get Form’ to open the sworn statement in the editor.
- Begin by filling out the Identification section. Enter your name, mailing address, city, state, phone numbers (home and work), date of birth, zip code, and driver license number. If you lack a driver license, select an alternative form of government-issued ID from the provided options.
- In the next section, check one box to indicate whether you are attaching a copy of the police report or providing the police case or offense number along with the name of the law enforcement agency.
- List any compromised account numbers in Section 3. Include names on each account and any check numbers that were lost or stolen. If necessary, indicate if this list continues on the back of the page.
- Finally, review your entries for accuracy. Sign and date where indicated to affirm that all information is true and correct before submitting it to your financial institution.
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