Social security disability fraud form 2025

1. Click ‘Get Form’ to open the social security disability fraud form in the editor.
2. Begin by filling out the 'Member Information' section. Enter your name, member number, and contact details including daytime, evening, and cell phone numbers. Ensure your mailing address is complete with city, state, and zip code.
3. In the 'Date Loss Discovered' and 'Date Loss Reported to Credit Union' fields, input the relevant dates. Specify the 'Date of First Fraudulent Transaction' to establish a timeline.
4. List all unauthorized transactions in the designated area. For each transaction, provide the date, recipient name/member number, and amount involved.
5. If known, include the name and address of the unauthorized user. Remember to enter your police report details including case number as this is mandatory for processing your claim.
6. Finally, sign and date the affidavit at the bottom of the form. If applicable, have a joint member sign as well. Don’t forget to notarize your affidavit before submission.

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