IC3 Form

Business or Personal

Are you reporting on behalf of a business?*

Yes No

Are you reporting an online incident, crime, scam, or a victimization of behalf of another person such as a parent, relative, or grandparent?*

Yes No

Tell us what happened.

Please describe the incident in your own words.*

When did the incident occur?*

Did the incident occur multiple times? If yes, please list additional dates and times.

Yes No

How would you categorize the incident?*

Financial fraud

Identity theft

Romance scam

Bullying

Hate speech

Online threat

Blackmail

Other

Are there witnesses or victims to this incident?

Yes No

How did the incident occur?

Please enter (or copy+paste) the initial text that was used to contact you. To learn how to copy and paste, please click here.

If it's easier, feel free to upload a screenshot of your email instead. You can learn how to do that here for Apple products or here for Android devices.

How did the incident occur?*

Did the incident involve a financial transaction such as transferring funds?*

Yes No

What was the total amount of the transaction?

Did you use a cash payment service?

Yes No

If the transaction involved a bank, please provide YOUR account information:

Your name: Your account number:

Bank name and address:

And now, the information of the recepient's bank, if available:

Their name: Their account number:

Bank name and address:

Were the funds transferred via an offline service?

Yes No

Alleged perpetrator information, if available:

First name Middle name Last name Business name Street address Street address 2 City State ZIP Code Country Phone Number Email address Website IP Address (If you don't know know this, feel free to leave this field blank). To learn how to find the IP address of an email sender, click here. Photo of perpetrator Anything we missed that might be helpful?

Victim contact information

First name Middle name Last name Business name Street address Street address 2 City State ZIP Code Country Best phone number to reach you: Best email address to reach you:

If you're filling out this form on behalf of someone else, please let us know how to reach you:

Relation to victim: First name Middle name Last name Business name Street address Street address 2 City State ZIP Code Country Best phone number to reach you: Best email address to reach you:

Reports to other agencies or law enforcmeent

If you have reported this incident to other law enforcement or government agencies, please provide:

name of agency or agencies
phone number
email
date reported
report ID
any other information that might help us cross-reference your case

Electronic Signature

Your full name*:

Click here if you'd like to print a copy of your completed form for your records.