Pa identity rev form 2026

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The document is an Identity Theft Affidavit (REV-1196) from the Pennsylvania Department of Revenue, designed for individuals who are victims of tax-related identity theft. It provides a form for victims to report their situation, request the opening of an identity theft claim, and place a fraud trigger on their tax account. The affidavit includes sections for personal information, a questionnaire regarding actions taken against identity theft, an explanation of how the identity was compromised, and a certification statement. Instructions for submission via mail, email, or fax are also included.

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Click ‘Get Form’ to open the PA Identity Rev Form in the editor.
Begin with SECTION I: PERSONAL INFORMATION. Fill in all required fields, including your name, address, and last four digits of your SSN. Ensure accuracy as this information is crucial for processing your claim.
In SECTION II: QUESTIONNAIRE, answer each question with a 'YES' or 'NO'. If applicable, provide supporting documents by attaching them directly within the editor.
Move to SECTION III: IDENTITY THEFT EXPLANATION. Use the text box to detail how your identity was compromised. You can attach additional sheets if necessary.
Finally, complete SECTION IV: CERTIFICATION. Sign and date the form digitally before submitting it through our platform for free.

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