Complaint Form - Internet Crime Complaint Center (IC3)
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Complaint Form - Internet Crime Complaint Center (IC3)
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Internet Crime Complaint Center (IC3)
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Who is Filing this Complaint?
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Complainant Information
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Financial Transaction(s)
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Information About The Subject(s)
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Description of Incident
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Other Information
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Privacy & Signature
* A red asterisk ( * ) indicates a required field.
* All other fields are optional. Please provide all requested information if possible, but these fields may be left blank.
* Do not provide complainant Personally Identifiable Information ( PII ) such as Social Security numbers or dates of birth anywhere in this form.
Confirm Action
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Yes, proceed
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No, cancel and return to form
Who is Filing this Complaint?
If you were the one affected by this incident, please indicate so below. In the event that you are completing this form on behalf of another individual or business, please select NO and provide your contact information.
* Were you the one affected in this incident?
Yes
No
Your Contact Information
* Name:
Business Name:
* Phone Number:
* Email Address:
Complainant Information
Please provide as much detail as possible related to the one affected by this incident. If you are reporting on behalf of a business, please include any Points-of-Contact ( POC s) at the business in the section below.
* Name:
Age:
Please select one...
Under 20
20 - 29
30 - 39
40 - 49
50 - 59
Over 60
* Is the complainant 17 years old or younger?
Yes
No
* Address:
Address (continued):
Suite/Apt./Mail Stop:
* City:
County:
* Country:
Please select one...
United States of America
Afghanistan
Åland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
* State:
Please select one...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands, U.S.
Virginia
Washington
West Virginia
Wisconsin
Wyoming
* Zip Code/Route:
* Phone Number:
* Email Address:
Business Information
Is this on behalf of a business that was targeted by a Cyber incident?
Yes
No
* Business Name:
* Is the incident currently impacting business operations?
Yes
No
If applicable, provide points of contact ( POC s) for this business.
Business IT POC:
Other Business POC:
If your business or organization is defined as a critical infrastructure entity, select the sector below:
None/Unsure
Chemical
Commercial Facilities
Communications
Critical Manufacturing
Dams
Defense Industrial Base
Emergency Services
Energy
Financial Services
Food and Agriculture
Government Facilities
Healthcare and Public Health
Information Technology
Nuclear Reactors, Materials, & Waste
Transportation Systems
Water & Wastewater Systems
If known or applicable, please select the critical infrastructure subsector:
None/Unsure
Basic
Specialty
Agriculture
Pharmaceuticals
Consumer Products
Entertainment and Media
Gaming
Lodging
Outdoor Events
Public Assembly
Real Estate
Retail
Sports Leagues
Terrestrial
Satellite
Wireless
Primary Metals
Machinery
Electrical Equipment
Appliance
Components
Transportation Equipment
Dams
Defense Industrial Base
Law Enforcement
Fire and Rescue
Emergency Medical
Emergency Management
Public Works
Electricity
Oil
Natural Gas
Solar
Depository Institution
Investment Product
Insurance Companies
Credit and Financing
Farming/Manufacturing
Processing/Storage
Restaurant
Federal Government Facility
State Government Facility
Local Government Facility
Education Facility
National Monument/Icon
Electoral System
Hospital
Other Medical Facility
Information Technology
Reactor
Materials
Waste
Aviation
Highway and Motor Carrier
Maritime
Mass Transit and Passenger Rail
Pipeline System
Postal and Shipping
Water & Wastewater Systems
Financial Transaction(s)
* Did you send or lose money in the incident?
Yes
No
* What was your total loss amount?
For the transaction information below:
* Provide the most recent transactions involved with this incident.
* Specify all money amounts below in US Dollars ( USD ).
* Originating account refers to where the funds were sent from; usually the Complainant's account.
* Recipient account refers to where the funds were sent to; usually a Subject's account.
* More information about the types of transactions can be found by clicking the help icon ( ) next to the Transaction Type field.
Transaction Type Definitions
Cash
Money in the form of coins or bills.
Check/Cashier's Check
A document that orders a bank, building society to pay a specific amount of money from a person's account to the person in whose name the check has been issued.
Cryptocurrency/Crypto ATM
Cryptocurrencies are digital tokens. Cryptocurrency payments may be made through an exchange or directly to the recipient. A Crypto ATM or kiosk that allows a person to purchase Bitcoin and other cryptocurrencies by using cash or debit card.
Debit Card/Credit Card
Payment cards that can be used in place of cash to make purchases. A debit card is usually linked to a bank account. A credit card is linked to a line of credit.
Money Order
A printed order for payment of a specified sum from prepaid funds, issued by a bank or Post Office.
Peer-to-Peer Transfer
A Peer-to-Peer (or P2P ) transaction is an electronic payment method via a third-party application or website that allows users to send money directly between two parties with separate bank accounts.
Prepaid/Gift Card
A prepaid/gift card is not linked to a bank or credit union account. Instead, money is deposited or "loaded" onto the card with a certain amount before the card can be used.
Wire Transfer
Types of electronic fund transfers to send money directly from one account to another. A wire transfer is a transaction initiated through a bank moving funds from one account to another at an external bank, can be domestic or international. This includes ACH transactions , which involve the transfer of funds between banks, credit unions, or other financial institutions through an electronic network.
Close
Routing Number Definition
A routing number (also known as an "RTN" or "ABA Routing Number") is a code used by financial institutions to identify one another, usually for electronic fund or wire transfers. It may have been provided as payment instructions by the individuals or organizations you are reporting
Close
SWIFT Code Definition
A SWIFT Code is an eight- or eleven-character code made up of letters and numbers that are used in international transfers of money. It may have been provided as payment instructions by the individuals or organizations you are reporting, particularly if the money is being sent to another country. For example: AAAABBC1 or AAAABBC1234
Close
Peer-to-peer Account Identifiers
Please use an email address or a phone number for an Account Identifier in a Peer-to-Peer transaction if possible.
Close
Type of CryptoCurrency
Type of cryptocurrency you sent as part of this transaction. (For example: Bitcoin, Ethereum, Tether, Litecoin, etc.)
Close
Transaction ID/Hash
Example: 0xfa485de419011ceefdd3cd00a4ff64e52bf9a0dfa528e4fff8bb4c9c . The ID/Hash is typically much longer than a crypto address or P2P account identifier.
Close
Cryptocurrency ATM/Kiosk
If you used a cryptocurrency ATM/Kiosk, include the type/name, such as Bitcoin Depot, CoinFlip, Margo, etc.
Close
ATM/Kiosk Address
Include the physical address of the ATM/Kiosk
Close
Originating Wallet Address
Your wallet address. Example: 0x58566904f57eac4E9EDd81BbC2f877865ECd35985 . An address is approximately 26-63 characters. If you do not have the whole address, include what you do have.
Close
Recipient Wallet Address
The wallet address where you sent funds. Example: 0x58566904f57eac4E9EDd81BbC2f877865ECd35985 . An address is approximately 26-63 characters. If you do not have the whole address, include what you do have.
Close
Type of Prepaid/Gift Card
The type of prepaid or gift card purchased as part of this transaction. (For example: Visa, MasterCard, Macys, Home Depot, Steam, etc.)
Close
Transaction #1
Remove Transaction
Transaction Type:
Please select one...
Cash
Check/Cashier's Check
Cryptocurrency/Crypto ATM
Debit Card/Credit Card
Money Order
Other
Peer-to-peer Transfer
Prepaid Card/Gift Card
Wire Transfer
* If other, please specify:
* Was the money sent or lost?
Yes
No
* Transaction Amount:
* Transaction Date:
Did you contact your bank, financial institution, or cryptocurrency exchange?
Yes
No
Originating Bank Name:
Originating Bank Address:
Originating Bank Address (cont.):
Originating Bank Suite/Mail Stop:
Originating Bank City:
Originating Bank Country:
[None]
United States of America
Afghanistan
Åland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Norway
Oman
Pakistan
Palau
Palestinian Territory, Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Originating Bank State:
[None]
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
United States Minor Outlying Islands
Utah
Vermont
Virgin Islands, U.S.
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Originating Bank Zip Code/Route:
Originating Name on Account:
Originating Account Number:
Type of Cryptocurrency:
P2P Application Used:
Transaction ID/Hash:
Cryptocurrency ATM/Kiosk:
Type of Prepaid/Gift Card:
ATM/Kiosk Address:
ATM/Kiosk City:
ATM/Kiosk Country:
[None]
United States of America
Afghanistan
Åland Islands
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic o
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- Business Email Compromise (BEC) [direct]
- Chinese Authority Impersonation [direct]
- Cryptocurrency [direct]
- Data Breach [direct]
- Elder Fraud [direct]
- Investment Fraud [direct]
- Other Common Scams [direct]
- Ransomware [direct]
- Tech/Customer Support and Government Impersonation [direct]
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