Report an Identity Theft Incident

Complete and submit this form when an identity theft red flag is detected in the course of university operations. Do not include any confidential information in your submission.

Section

Contact Name:

Contact Email:

Contact Phone Number:

Department/Unit:

Date of Incident:

Red Flag Type (choose all that apply):

Alert, notification, or warning from consumer credit reporting agencySuspicious document(s)Suspicious identifying informationSuspicious account activityNotice from other sources

Describe the red flag detected and subsequent actions: