IRS 14039 PDF Template

The IRS 14039 form is a document used by taxpayers to report suspected identity theft related to their tax records. By submitting this form, individuals can alert the IRS to potential fraud and take steps to protect their financial information. If you believe you may be a victim, consider filling out the form by clicking the button below.

Article Guide

When it comes to safeguarding your identity, understanding the IRS Form 14039 is crucial. This form serves as a protective measure for individuals who suspect that their personal information has been compromised and may be used fraudulently to file tax returns. By submitting Form 14039, taxpayers can alert the IRS to potential identity theft, prompting the agency to take necessary steps to secure their accounts. The form requires individuals to provide personal information, including their name, Social Security number, and a description of the suspected identity theft. Additionally, it is essential to understand that filing this form does not automatically guarantee a resolution; rather, it initiates a process that may involve further investigation by the IRS. As identity theft continues to be a pressing concern, familiarizing oneself with the nuances of Form 14039 can empower individuals to protect their financial well-being and ensure their tax-related matters are handled with care.

IRS 14039 Preview

Form 14039

(May 2024)

Department of the Treasury - Internal Revenue Service

Identity Theft Affidavit

OMB Number

1545-2139

This affidavit is for victims of identity theft. To avoid delays do not use this form if you have already filed a Form 14039 for this incident.

Form 14039 can also be completed online at https://www.irs.gov/dmaf/form/f14039.

The IRS process for assisting victims selecting Section B, Box 1 below is explained at irs.gov/victimassistance.

Get an IP PIN: We encourage everyone to opt-in to the Identity Protection Personal Identification Number (IP PIN) program. If you don’t have an IP PIN, you can get one by going to irs.gov/ippin. If unable to do so online, you may schedule an appointment at your closest Taxpayer Assistance Center by calling (844-545-5640). Or, if eligible, you may use IRS Form 15227 to apply for an IP PIN by mail or FAX, also available by going to irs.gov/ippin.

Section A - Check the following boxes in this section that apply to the specific situation you are reporting (required for all filers)

1. I am submitting this Form 14039 for myself

2. I am submitting this Form 14039 in response to an IRS Notice or Letter received

•Provide ‘Notice’ or ‘Letter’ number(s) on the line to the right

•Check box 1 in Section B and see special mailing and faxing instructions on reverse side of this form.

3. I am submitting this Form 14039 on behalf of my dependent child or dependent relative (include that person’s information below in Section C and D)

•Complete Sections A-F of this form. Do not use this form If dependent’s identity was misused by a parent or guardian in filing taxes, this is not identity theft.

4. I am submitting this Form 14039 on behalf of another person living or deceased (other than my dependent child or dependent relative)

• Complete Sections A- F of this form.

Section B – How I Am Impacted (required when reporting misuse of Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN))

Check all boxes that apply to the person listed in Section C below. If the person in Section C has previously submitted a Form 14039 for the same incident, there’s no need to submit another Form 14039.

1. I know or suspect that someone used my information to fraudulently file a federal tax return

I/My dependent was fraudulently/incorrectly claimed as a dependent (use that person’s information for Section C & D)

My SSN or ITIN was fraudulently used for employment purposes

Note: If you are a victim of Identity theft but it does not involve your federal tax return, you should request an IP PIN to protect yourself. Get An Identity Protection PIN | Internal Revenue Service (irs.gov)

Provide an explanation of the identity theft issue, how it impacts your tax account, when you became aware of it and provide relevant dates. If needed, attach additional information and/or pages to this form

Section C – Name and Contact Information of Identity Theft Victim (required)

Victim’s last name

First name

Middle

Taxpayer Identification Number

initial

(provide 9-digit SSN or ITIN)

Current mailing address (apartment or suite

number and street, or P.O. Box)

Current city

State

ZIP code

If deceased, provide last known address

Address used on last filed tax return (if different than ‘Current’)

City (on last tax return filed)

State

ZIP code

Telephone number with area code. The IRS may call you regarding this affidavit

Best time(s) to call

Home phone number

Cell phone number

Language in which you would like to be contacted

English

Spanish

Other

Section D – Tax Account Information: Last tax return filed (year shown on the tax return) and Returns Impacted

I was not required to file a return or filed a return with no income information

Names used on last filed tax return

The last tax return filed (year shown on the tax return)

What Tax Year(s) you believe were impacted by tax-related identity theft (example: 2020 is input for citing the 2020 tax return though filed the next year(s). (if not known, enter ‘Unknown’ below))

Submit this completed form to either the mailing address or the FAX number provided on the reverse side of this form.

Catalog Number 52525A

www.irs.gov

Form 14039 (Rev. 5-2024)

Section E – Penalty of Perjury Statement and Signature (required)

Under penalty of perjury, I declare that, to the best of my knowledge and belief, the information entered on this Form 14039 is true, correct, complete, and made in good faith.

Signature of taxpayer, or representative, conservator, parent or guardian

Date signed

Section F – Representative, Conservator, Parent or Guardian Information (required if completing Form 14039 on someone else’s behalf)

Check only ONE of the following five boxes next to the reason you are submitting this form

1.The taxpayer is deceased, and I am the surviving spouse

•No attachments are required, including death certificate.

2.The taxpayer is deceased, and I am the court-appointed or certified personal representative

•Attach a copy of the court certificate showing your appointment.

3.The taxpayer is deceased, and a court-appointed or certified personal representative has not been appointed

•Attach copy of death certificate or formal notification from a government office informing next of kin of the decedent’s death.

• Indicate your relationship to decedent:

Child

Parent/Legal Guardian

Other

4. The taxpayer is unable to complete this form and I am the appointed conservator, or I have been authorized to act on behalf of the taxpayer per Form 2848, Power of Attorney and Declaration of Representative

•Attach a copy of documentation showing your appointment as conservator or Power of Attorney authorization.

•If you have an IRS issued Centralized Authorization File (CAF) number, enter the nine-digit number:

5. The person listed above is my dependent child or my dependent relative

By checking this box and signing below you are indicating that you are an authorized representative, as parent, guardian or legal guardian, to file a legal document on the dependent’s behalf.

• Indicate your relationship to person	Parent/Legal Guardian	Power of Attorney
Fiduciary per IRS Form 56, Notice of Fiduciary Relationship		Other

Parent’s/Representative's name
Last name	First name		Middle initial

Parent’s/Representative’s current mailing address (city, town or post office, state, and ZIP code)

Parent’s/Representative’s telephone number

Instructions for Submitting this Form

Submit this completed and signed form to the IRS via Online, Mail or FAX to specialized IRS processing areas dedicated to assist you. In Section C of this form, be sure to include the Social Security Number in the ‘Taxpayer Identification Number’ field.

Help us avoid delays:

•Do not use this form if you have already filed a Form 14039 for this incident.

•Choose one method of submitting this form either Online (preferred method), by Mail, or by FAX, not all methods.

•Provide clear and readable photocopies/images of any additional information you may choose to provide.

•Submit the original tax return to the IRS location where you normally file your tax return. Do not use the following address or fax number to file an original tax return.

	Online (Preferred Method)		Submitting by Mail
• https://www.irs.gov/dmaf/form/f14039		•	If you checked Box 2 in Section A in response to a notice or letter
			received from the IRS, return this form and if possible, a copy of the
	Submitting by FAX
	Submitting by FAX		notice or letter to the address contained in the notice or letter.
• Always include a cover sheet marked "Confidential”.		•	If you checked Box 1 or 2 in Section B of Form 14039 and are unable
• If you checked Box 2 in Section A of Form 14039 and are submitting			to file your tax return electronically because the SSN/ITIN of you,
	this form in response to a notice or letter received from the IRS. If it		your spouse, or dependent was misused, attach this Form 14039 to
	provides a FAX number, you should send there.		the back of your paper tax return and submit to the IRS location where
•	If no FAX number is shown on the notice or letter, follow the mailing		you normally file your tax return.
•		•	All others should mail this form to:
	instructions on the notice or letter.	•	All others should mail this form to:
•	For all others, FAX this form toll-free to:		Department of the Treasury
•	For all others, FAX this form toll-free to:		Internal Revenue Service
	855-807-5720		Internal Revenue Service
	855-807-5720		Fresno, CA 93888-0025
			Fresno, CA 93888-0025

	Privacy Act and Paperwork Reduction Notice

Our legal authority to request the information is 26 U.S.C. 6001. The primary purpose of the form is to provide a method of reporting identity theft issues to the IRS so that the IRS may document situations where individuals are or may be victims of identity theft. Additional purposes include the use in the determination of proper tax liability and to relieve taxpayer burden. The information may be disclosed only as provided by 26 U.S.C. 6103. Providing the information on this form is voluntary. However, if you do not provide the information it may be more difficult to assist you in resolving your identity theft issue. If you are a potential victim of identity theft and do not provide the required substantiation information, we may not be able to place a marker on your account to assist with future protection. If you are a victim of identity theft and do not provide the required information, it may be difficult for IRS to determine your correct tax liability. If you intentionally provide false information, you may be subject to criminal penalties. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103. Public reporting burden for this collection of information is estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send this form to this address. Instead, see the form for filing instructions. Notwithstanding any other provision of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act, unless that collection of information displays a currently valid OMB Control Number.

Catalog Number 52525A

www.irs.gov

Form 14039 (Rev. 5-2024)

↓ IRS 14039

File Properties

Fact Name	Description
Purpose	The IRS Form 14039 is used to report identity theft related to tax issues.
Eligibility	Any taxpayer who suspects their identity has been used fraudulently to file a tax return can use this form.
Filing Method	The form can be submitted electronically or via mail, depending on the circumstances.
Required Information	Taxpayers must provide personal identification details, including their name, Social Security number, and contact information.
State-Specific Forms	Some states have their own identity theft reporting forms, governed by state laws such as California's Civil Code § 1798.92.
IRS Response	Upon receipt, the IRS will review the claim and may issue a PIN to help protect the taxpayer's identity in the future.
Impact on Refunds	Filing this form can delay tax refunds while the IRS investigates the identity theft claim.
Additional Resources	The IRS provides guidance on its website for individuals who suspect identity theft, including how to use Form 14039.

Instructions on Utilizing IRS 14039

After obtaining the IRS Form 14039, you will need to complete it accurately to address your situation. Following the steps outlined below will help ensure that the form is filled out correctly.

Begin by downloading the IRS Form 14039 from the official IRS website or obtain a physical copy.
Carefully read the instructions provided with the form to understand the required information.
In the first section, provide your personal information, including your name, address, and Social Security number.
Indicate whether you are a victim of identity theft by checking the appropriate box.
In the next section, describe the circumstances of your identity theft. Be as detailed as possible, including dates and any relevant information.
If you have any supporting documents, gather them and make copies to attach to the form.
Review all the information you have entered to ensure accuracy and completeness.
Sign and date the form at the bottom where indicated.
Make a copy of the completed form and any attachments for your records.
Mail the form to the address specified in the instructions.

Important Facts about IRS 14039

What is the IRS Form 14039?

The IRS Form 14039, also known as the Identity Theft Affidavit, is a document used by individuals to report that they have been victims of identity theft. This form helps the IRS take necessary actions to protect the taxpayer’s account and rectify any fraudulent activity associated with their Social Security number.

Who should file Form 14039?

Anyone who believes their personal information has been used fraudulently to file a tax return or to gain other benefits should file Form 14039. If you receive a notice from the IRS indicating that more than one tax return has been filed using your Social Security number, you should also consider filing this form.

How do I complete Form 14039?

To complete Form 14039, provide your personal information, including your name, address, and Social Security number. Clearly explain the circumstances of the identity theft in the designated section. Make sure to sign and date the form before submitting it to the IRS.

Where do I send Form 14039?

You should send Form 14039 to the address indicated in the instructions on the form. Typically, this is the address for the IRS office that handles identity theft cases. If you are unsure, check the IRS website for the most current information.

What happens after I submit Form 14039?

After submitting Form 14039, the IRS will review your case. They may contact you for additional information or clarification. The IRS will take steps to protect your account and may issue you an Identity Protection Personal Identification Number (IP PIN) to help prevent future identity theft.

Can I file Form 14039 electronically?

No, Form 14039 cannot be filed electronically. You must print the completed form and mail it to the IRS. This is to ensure that all sensitive information is securely handled.

Is there a deadline for filing Form 14039?

While there is no strict deadline for filing Form 14039, it is important to submit it as soon as you suspect identity theft. Prompt reporting can help the IRS take action quickly and minimize any potential damage to your tax account.

Will filing Form 14039 affect my tax refund?

Filing Form 14039 may delay your tax refund if the IRS needs to investigate your claim further. However, it is crucial to report identity theft to protect your financial information. The IRS will work to resolve any issues and ensure that you receive any refunds you are entitled to.

Can I get assistance with filing Form 14039?

Yes, you can seek assistance from a tax professional or a local taxpayer advocate. The IRS also provides resources and guidance on its website to help individuals understand the process of filing Form 14039 and addressing identity theft issues.

Common mistakes

Filling out IRS Form 14039, the Identity Theft Affidavit, is a crucial step for anyone who suspects that their personal information has been compromised. However, many individuals make common mistakes that can delay the resolution of their issues or even complicate their cases. Understanding these pitfalls can help you navigate the process more smoothly.

One frequent error is not providing complete information. When filling out the form, it's essential to include all requested details, such as your full name, address, and Social Security number. Omitting even a small piece of information can lead to processing delays, as the IRS may need to reach out for clarification. Ensuring that every field is filled out accurately can save time and frustration.

Another common mistake is failing to sign and date the form. It may seem trivial, but an unsigned affidavit is essentially invalid. The IRS requires your signature to confirm that the information you provided is true and correct. Always double-check that you have signed and dated the form before submitting it.

Some people also mistakenly submit the form to the wrong address. It’s important to send your completed Form 14039 to the correct IRS office. The address can vary based on your location and the specifics of your case. Always verify the appropriate address on the IRS website or through official IRS publications to ensure your form reaches the right destination.

Additionally, individuals often neglect to keep copies of their submissions. After sending in your Form 14039, retaining a copy for your records is vital. This documentation can be helpful if you need to follow up with the IRS or if there are any discrepancies in the future. Keeping a record can provide peace of mind and serve as proof of your actions.

Another mistake is not following up after submitting the form. Once you’ve sent in your affidavit, it’s wise to monitor the situation closely. The IRS may take time to process your request, but checking in can help ensure that your case is moving forward. If you don’t receive any communication after a reasonable period, reaching out to the IRS can clarify the status of your claim.

Finally, many individuals ignore additional instructions provided with the form. The IRS often includes specific guidance or requirements that can vary based on individual circumstances. Carefully reading and adhering to these instructions can prevent unnecessary complications. Taking the time to understand the process fully can make a significant difference in the outcome of your case.

Documents used along the form

The IRS Form 14039, also known as the Identity Theft Affidavit, is a critical document for individuals who suspect that their personal information has been misused for tax-related purposes. When filing this form, individuals may also need to submit additional documents to support their claims or to facilitate the resolution of identity theft issues. Below is a list of other forms and documents that are often used in conjunction with Form 14039.

Form 1040: This is the standard individual income tax return form used by U.S. taxpayers to report their annual income, calculate taxes owed, and claim refunds.
Form 4868: This form is used to request an automatic extension of time to file an individual income tax return. It is important for those needing more time due to identity theft issues.
Form 8821: This form allows taxpayers to authorize an individual to receive and inspect their confidential tax information from the IRS, which may be necessary for resolving identity theft cases.
Form 14039-B: This is a supplementary affidavit for individuals who have had their identity stolen in connection with a business tax return, providing additional context for the IRS.
Identity Theft Report: A report filed with law enforcement that provides evidence of identity theft, which can support claims made on Form 14039.
Credit Report: A document that shows an individual's credit history and accounts. It can help identify unauthorized accounts opened in the victim's name.
Form W-2: This form reports an employee's annual wages and the taxes withheld. It may be needed to verify income if identity theft has occurred.
Form 1099: Similar to Form W-2, this form reports various types of income other than wages, such as freelance work, which may be relevant in identity theft cases.
Form 941: This is the employer's quarterly federal tax return. If identity theft involves employment-related issues, this form may be necessary.
Form 4506-T: This form allows taxpayers to request a transcript of their tax return, which can be helpful in verifying past filings and identifying discrepancies.

In summary, while the IRS Form 14039 is essential for reporting identity theft, various other forms and documents can assist in addressing the complexities that arise from such incidents. Collectively, these documents help individuals navigate the process of resolving identity theft and restoring their financial integrity.

Similar forms

The IRS Form 14039, also known as the Identity Theft Affidavit, serves a specific purpose in the context of reporting identity theft related to tax issues. There are several other documents that share similar functions or objectives. Below is a list of six such documents, each accompanied by a brief explanation of how it relates to Form 14039.

Form 4506-T: This form allows taxpayers to request a transcript of their tax return. Similar to Form 14039, it can be used to verify information when identity theft is suspected, helping to clarify discrepancies in tax records.
Form 14039-B: This is a variation of the Identity Theft Affidavit specifically for businesses. Like Form 14039, it is used to report identity theft but focuses on business-related tax issues, ensuring that businesses can also protect their identities.
Form 8821: This form is used to authorize the IRS to disclose tax information to a third party. In cases of identity theft, it can be similar to Form 14039, as it allows individuals to grant access to their tax records for verification purposes.
Form 1040: The standard individual income tax return form. While its primary function is to report income, it may also be used in conjunction with Form 14039 when discrepancies arise due to identity theft, helping to clarify the taxpayer's actual financial situation.
Form 8862: This form is used to claim the Earned Income Tax Credit after it has been denied. If identity theft has led to a denial, Form 8862 may be submitted alongside Form 14039 to rectify the situation and reclaim eligibility for the credit.
Form 1040-X: This is the amended tax return form. If identity theft has resulted in incorrect information being filed, Form 1040-X can be used to correct those errors, similar to how Form 14039 addresses issues stemming from identity theft.

Dos and Don'ts

When filling out the IRS Form 14039, it's important to be careful and thorough. Here’s a list of things you should and shouldn't do:

Do double-check your personal information for accuracy.
Do provide a clear explanation of why you believe your identity has been compromised.
Do sign and date the form before submitting it.
Do keep a copy of the completed form for your records.
Don't leave any required fields blank.
Don't submit the form without reviewing it for errors.

Misconceptions

The IRS Form 14039, also known as the Identity Theft Affidavit, is often misunderstood. Here are seven common misconceptions about this form:

It is only for individuals who have had their identity stolen. Many believe that this form is exclusively for those who have experienced identity theft. However, it can also be used by individuals who suspect their information may be misused.
Filing the form guarantees a resolution. Some think that submitting Form 14039 will automatically resolve their tax issues. In reality, it initiates an investigation, but resolution may take time and further action may be necessary.
Once filed, the IRS will immediately contact you. Many expect prompt communication from the IRS after submitting the form. However, the agency may take weeks or even months to respond, depending on their workload.
It can only be filed in paper form. There is a misconception that Form 14039 must be submitted in paper format. In fact, individuals can also file it electronically in certain situations, streamlining the process.
Only tax returns affected by identity theft require this form. Some believe that the form is only necessary when a tax return has been filed fraudulently. However, it can also be used to report any suspicious activity related to one’s personal information.
Filing the form prevents future identity theft. While submitting Form 14039 is an important step, it does not provide protection against future identity theft. Individuals should take additional precautions to safeguard their personal information.
It's a lengthy and complicated process. Many fear that completing the form is overly complex. In truth, the form is straightforward and can be filled out in a relatively short amount of time.

Understanding these misconceptions can help individuals navigate the complexities of identity theft and the IRS process more effectively.

Key takeaways

The IRS Form 14039, also known as the Identity Theft Affidavit, is a crucial document for individuals who believe their personal information has been compromised. Here are some key takeaways about filling out and using this form:

Purpose: The form is designed to report identity theft and help victims protect their tax records.
Eligibility: Anyone who suspects their identity has been used fraudulently to file a tax return can use this form.
Filling Out the Form: Provide accurate personal information, including your name, address, and Social Security number.
Documentation: Attach any supporting documents that prove your identity theft claim, such as police reports or correspondence from the IRS.
Submission: Send the completed form to the address specified in the form instructions, which may vary based on your situation.
IRS Response: After submission, the IRS will review your claim and may contact you for additional information.
Follow-Up: Keep copies of all documents sent and received for your records, as this can be important for future reference.
Identity Protection: Consider enrolling in identity theft protection services to monitor your personal information.
Stay Informed: Regularly check your credit reports and IRS records to ensure no further fraudulent activity occurs.

Using the IRS Form 14039 effectively can help safeguard your tax records and assist in resolving identity theft issues. Always ensure that you fill out the form completely and accurately to avoid delays in processing your claim.