Wireless Service Fraud Inquiry Form
Use this form to report suspected wireless account fraud or unauthorized wireless service activity and share the details needed for review.
Reporter Information
Full Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Method
*
Email
Phone
Text
Wireless Account and Carrier Details
Wireless carrier/provider name
*
Account holder name (if different from reporter)
First Name
Middle Name
Last Name
Account number or reference number
Affected wireless phone number(s)
*
Fraud Incident Details
Type of Fraud Incident
*
Unauthorized account access
SIM swap or port-out
Unauthorized line added
Unauthorized device change
Unauthorized charges or plan change
Lost or stolen device misuse
Identity misuse on wireless account
Other
Incident Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Date First Noticed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was the account accessed or changed without your permission?
*
Yes
No
Not sure
Describe What Happened
*
Affected Services and Evidence
Impacted Line or Lines
*
Device Model or Device Identifier
Unauthorized Service Changes
Unauthorized Charges or Fees Observed
Current Service Status
*
Active
Recovered
Partially Restored
Unknown
Supporting Evidence Upload
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Follow-up and Submission Details
Preferred follow-up method
*
Email
Phone
Text message
No follow-up needed
Best time to contact
Hour Minutes
AM
PM
AM/PM Option
Additional instructions or notes for the fraud review team
Submit Fraud Inquiry
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