Use this form only when a photo identification was made at the time the check was written. Driver's licenses (any state) or Texas ID cards are acceptable ID's. You must furnish us with the name of the person who witnessed the signing of the check.
(Merchant Filing of Complaint)
Use this form only when no photo identification was made or when the person who verfied the indentification is unknown.
Form 3: "Theft by Check Information Sheet"
Use this form only with either form 1 or 2 if your check is over $150.00. Certified letters are required on all checks $150.00 or over. If your check is marked account closed, no notification is required.
- All Signatures must be original.
- Copies must be legal size (8 1/2x13).
- When filing through the mail, verify all forms are completed and notarized.
For your convenience in filing with our office mail the forms to:
P.O. Box 1748
Austin, Texas 78767
The following steps will help speed up the process:
- Staple the original check to the top left hand corner of the form you use.
- Attach only the receipt for the certified letter or the green card.
- Attach invoices or receipts for all amounts of $150.00 and over. Always staple these on the back of the forms.
- Other information from the check collections you use is not necessary. (Do not cover the checks with these.)
- All forms must be signed and stamped by the notary.
- Be sure you put, on the affidavit, what merchandise was puchased, such as clothing, jewelery, groceries etc.
- Always sign your name (if you are the one filling out the form) Do not sign the company name as affiant on the affidavit.