Unauthorized Account Closure Report Form
Use this form to report and provide details about an account closure that you believe was performed without your authorization. Please provide as much detail as possible to assist with the investigation.
Your Full Name
*
First Name
Last Name
Your Contact Email
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the Account
*
Account Holder
Authorized Representative
Family Member
Other
Account Reference or Username (do not enter sensitive numbers)
*
Date You Discovered the Account Was Closed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
How did you discover the account was closed?
*
Tried to log in and received a closure message
Received notification from the organization
Notified by a third party
Other
Describe the Incident and Any Actions Taken
*
Upload Any Evidence or Documentation (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
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What impact has this closure had on you, and what resolution are you requesting?
*
Submit Report
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