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Arrested Fraud Victim Intake Form

PLEASE READ CAREFULLY BEFORE FILLING OUT THE FORM

THIS FORM IS FOR FRAUD VICTIMS IN THE US, CANADA, UK, AND AUSTRALIA

If you have not been arrested but are at risk of arrest, please go here: At Risk of Arrest Fraud Victim Form

DO NOT USE AUTO FILL FOR YOUR NAME AND CONTACT INFORMATION!
IF YOU USE AUTO FILL WE WILL NOT RECEIVE YOUR CONTACT INFORMATION
CORRECTLY AND WE WILL BE UNABLE TO HELP YOU.

Only those staff members working on your case receive information about your case.  Those who work on your case are Fraud Aid trained Senior Fraud Victim Advocates.  They are professional men and women (Certified Fraud Examiners and trained former fraud victims).

We are not attorneys; you do not have attorney/client privilege when you speak with us.  HOWEVER, we will not share your information with law enforcement or the courts without a court order to do so. 

We have been working with creditors and Criminal Defense Attorneys (pubic and private) since the spring of 2003, shortly after the inception of the Eastern European and Nigerian counterfeit check / money laundering scams and reshipping scams.  We work with Criminal Defense Attorneys and Public Defenders regardless of the nature of the scam, and regardless of whether the scam is domestic or international.  Our goal is always geared to the best interest of the victim who comes to us.  We also take into account the position of the creditor (also a victim) in order to reach a solution that is amicable to both parties.

Note: We will assist you no matter what your current resident immigration status is.

Current Status

I was arrested on  

I am at risk of arrest (or) I have received a notice/warrant from the court.  This button automatically re-directs you to the Risk of Arrest Fraud Victim Intake Form.

 

A. Name and Contact Information

First    Last

Email:   Verify Email:

Address:

Street (Optional)  

City or Town:

US or UK County

State (Province/Territory/)

Postal Code:

Country:   (Currently we can only assist residents of Australia, Canada, the UK, and the US)

 

Telephone: (US and Canada area codes only)

Time Zone: 

Home phone:      (Ex. 555-555-5555)  Best time to call:

Work phone:   (Ex. 555-555-5555)  Best time to call:

Cell phone:   (Ex. 555-555-5555)  Best time to call:

Other:

Name:   

Relationship: 

Phone:  (Ex. 555-555-5555)  Best time to call:

 


B. US Residents or Visitors

Are you a US citizen?   Yes      No   

If No, are you in the US on a:

Work visa

Student visa

Tourist visa

Spouse visa

Fiancé or fiancée visa

Other visa 

None of the above  NOTE: If your visa is no longer current or if you are in the US without a visa, please contact an immigration attorney immediately (see Legal Aid for your resident area).  We will help you resolve your situation regardless of your resident status.

What is your native country?

 


C. About your Arrest

Where were you arrested (geographical area):

In the same city or town as where you live

In a different city or town than where you live

In a different county than where you live

In a different state than where you live  

In a different country than where you live:

 

Where were you arrested (specific location):

At a store   Name of store:

At a bank or credit union    Name of bank or credit union:

At home

At work 

Other 

 

You were arrested by:   Local police    State police    Sheriff     FBI    Secret Service   Homeland Security    RCMP   Other:

 

Name of arresting authority (Ex. Dade County Sheriff's Department, St. Louis FBI Field Office, New York Police Precinct # ___)

  

 


D. Type of Scam:

Type of scam

High yield investment scheme

Hired on the Internet to: (check all that apply)

Reship merchandise

Reship checks and/or money orders

Write checks

Re-wire funds received by Western Union

Process payments, collections, investment deposits, charity donations, etc.

Be a secret shopper

Other

Drafts = all types of checks or money orders including Traveler's checks, gift checks, and local or federal government checks

Cash / deposit drafts for an Internet friend or sweetheart

Cash / deposit drafts for a friend or relative (not Internet)

Cash / deposit drafts from lottery, Sweepstakes, contest, Rewards Program, raffle, or other winnings

Cash / deposit drafts from inheritance, foreign government invoice, transfer a foreigner's money, or similar request

Receive and forward funds wired into a: (check all that apply)

Bank account

Credit card account

Portfolio / investment account

Other type of scam


E. Reason for Arrest:

Middleman in a High Yield investment scheme

Middleman in an online auction or Classified Ads scam, or offline Classified Ads scam

Took stolen Walmart money orders to Walmart

Took counterfeit / forged checks to bank or credit union on which they were drawn

Took counterfeit / forged checks or money orders to a check cashing store or other store

Took counterfeit / forged checks or money orders to a casino

Presented counterfeit / forged checks or money orders to my bank or credit union for cash or deposit (transaction not completed)

Forwarded stolen funds wired into my bank, credit card, investment, or other account

Re-shipped merchandise purchased with a stolen credit card

Wrote checks on banks or credit union accounts that don't belong to me

Re-wired stolen money received by Western Union

Ignored bank or credit union's request for repayment

Ignored store's request for repayment

Other (please explain briefly): Maximun of 700 characters including spaces and punctuation.

 


F. Money owed to store, bank, credit union, investors, or other parties from the cause of arrest:

I did not spend or forward any money

I owe a total of:

Money is owed to:

 


G. Indictment

Have you received your indictment?    Yes  No

Have you received a notice from the court?  Yes  No

If yes to either of the above:

What is the name of the court?

What are the exact charges on the indictment?


H. Arraignment and/or Pre-trial

Does the Court use arraignment    Pre-trial  Both

Have you been arraigned?  Yes   No

If you answered yes:  

My attorney was present  (This includes an attorney temporarily assigned to you at the arraignment)

My attorney was not present  

The arraignment was continued while I find a private Defense Attorney  

                                                                                 New arraignment date: (day, month, year)

The arraignment was continued pending the assignment of a Public Defender 

                                                                                 New arraignment date: (day, month, year)

If you answered no:

What is the date of your arraignment?  (day, month, year)

Can you afford a Criminal Defense Attorney?    Yes  No

If yes, have you contacted a Criminal Defense Attorney?   Yes   No

If no, have you contacted the Public Defender's Office?   Yes   No

 

If pre-trial:

What is the date of your pre-trial? (day, month, year)

_____________________________________________________________________________

PLEASE REVIEW YOUR ANSWERS BEFORE SUBMITTING.  One of our Fraud Victim Advocates will be in touch
with you to review your situation and to assist you and your attorney.

 

 

   

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