Form Center

2. Identity Theft Witness Statement
   Instructions: Please fill out this form prior to filing a police report regarding an identity theft case. Completing this form does NOT substitute for filing a police report. This form must be printed and submitted in person at Allen Police Headquarters (205 W. McDermott Drive) when you file your police report.
4. I understand that I am not under arrest or detained in any manner.
6. My name is:*
7. My birth date is:*
8. (Office Use Only)
   
10. Address:*
11. City:*
12. State:*
13. Zip Code:*
15. My occupation is:
16. I am employed by:
18. My home phone number is:*
19. My work phone number is:*
21. My cell phone number is:*
22. My email address is:*
24. I am voluntarily making this statement to a Police Officer for the City of Allen, Collin County, Texas.
26. Voluntary Statement*
28. I have read this statement and certify under penalty of perjury that the facts contained herein are true and correct.
30. Your Signature (sign after printing):
    ___________________________________________________________________________________________
32. Witness 1 Signature (sign after printing):
    ___________________________________________________________________________________________
34. Witness 2 Signature (sign after printing):
    ___________________________________________________________________________________________
36. (Office Use Only)
    
Leave This Blank:


37. Print Only

* indicates a required field