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Printable Form 14039 Rockford Illinois: What You Should Know

The completed questionnaire shall be attached as a separate item and kept with the purchase order in the case file. The completed questionnaire should be the following: 1. Have you or anyone you know ever been the victim of fraud or unauthorized use, by someone using someone else's taxpayer identification number(s) for a credit card or debit card? 2. Are you aware that someone you know is the victim of identity theft? 3. Are you aware that someone you know has received or is receiving a fraudulent bill or debt? 3 4. Are you aware that your taxpayer identification number(s) has been involved in any identity theft activity? 5. Have you received reports of such identity theft and, if so, what is the information contained in these reports? 6. What kind and frequency of identity theft have you personally experienced? 7. Do you know how to contact the Identity Protection Hotline for additional information? 8. Is there a record of the identity theft(s) to which one of your tax account(s) has been or may be related? 9. If the answer to the above questions is yes, the identity theft(s) would have to be at least 3 months prior to the sale of any tax account(s) for you to be liable for the amount of tax due on a fraudulent purchase order. The identity theft verification questionnaire must be received no later than 8 days prior to the date of sale of a tax account. If the identity theft questionnaire is not received or is postmarked later than 8 days prior to the sale of any tax account(s), you and anyone you identify may be liable for the unpaid amount of tax due on a fraudulent purchase order. The identity theft questionnaire may be given by mail under the following conditions: a. It must be postmarked by the day of sale, and b. It must be postmarked by a U.S. location. If the identity theft questionnaire is not completed, the salesperson may be subject to prosecution. The identity theft questionnaire may be included in telephone calls. The salesperson, who knows the identity of the person asking for the questionnaire, may not divulge any financial or personal information, including but not limited to Social Security numbers or date of birth, unless there is a good reason to do so. The identity theft questionnaire may be sent by electronic mail, fax or electronic mailing.

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