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Telephone: ________
Email: ________

Date: ________

Office of the Attorney General — State of Alabama
Attn: Consumer Protection Division
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Re: Identity Theft Complaint — Misuse of Personal Employment Records
Complainant: ________
Respondent: ________

To Whom It May Concern:

§ 1. Introduction. I respectfully submit this written complaint to the Office of the Attorney General regarding the unauthorized use and misuse of my personal and employment records by ________ (the “Respondent”). I believe these acts constitute identity theft and/or the unauthorized use of my identifying information in violation of applicable federal and state law, including the Identity Theft and Assumption Deterrence Act (18 U.S.C. § 1028), the Fair Credit Reporting Act (15 U.S.C. § 1681 et seq.), the Federal Trade Commission Act (15 U.S.C. § 45), and the consumer protection and identity theft statutes of the State of Alabama.

§ 2. Statement of Facts. I first became aware of the misuse of my personal and employment records on or about ________. The nature of the misuse and the harm I have suffered are described as follows:

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§ 3. Identifying Information Affected. The personal identifying information believed to have been misused includes the following:

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§ 4. Prior Contact With Respondent. I contacted ________ on ________ and explained that this situation was unsatisfactory and must be remedied. The Respondent provided me with the following response:

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§ 5. Basis for This Complaint. The failure of ________ to provide an appropriate response or remedy in a timely fashion has prompted me to contact the Office of the Attorney General. I respectfully request that the Respondent be required to take the following action to remedy this matter:

________.

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§ 7. Enclosures. Enclosed for your reference are the following documents related to this matter:

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§ 8. Verification. I declare under penalty of perjury under the laws of the United States and the State of Alabama that the foregoing statements are true and correct to the best of my knowledge, information, and belief, and that the information provided herein is submitted in good faith.

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Thank you for your time and prompt attention to this serious matter.

Sincerely,

_______________________________
________
Date: ________

Enclosures: ________