You are completing an online report for Identity Theft and you are a resident of Fishers, Indiana. This report is intended for situations where someone is using your personal information without permission and you have no suspects. If you do not meet these requirements, please call 317-773-1282 to file a report with a police officer. Please write a detailed narrative including who, what, when, where and how.

When did this incident occur? Please include start and end (if applicable) times and dates.

Please give a detailed description of this incident.

Your Information

Name:*

Date of Birth*

Driver's License Number

Drivers License State of Issue

Race*

Gender*

Street Number and Name:*

Address Line 2:

City:*

State:*

Zip Code:*

Phone Number:*

Fax Number:

Email Address:*

Preferred Contact Method:*

Do NOT contact me Email

Employer

Employer Address

Employer City

Employer Zip

Employer Telephone