Please fill in the following
information and send it to me.

See below for more information.

Name ___________________________________

Address ___________________________________

Social Security Number ___________________________

Phone Number _______________________________

Phone Password/Code _________________________________

Drivers License Number ____________________________________

Passport Number ___________________________________

Credit Card Number __________________________________

Three-Letter Code On Back Of Credit Card ___________________________________

Credit Card Expiration Date __________________________________________

Bank Name ______________________________________

Bank Account Number _____________________________

Debit Card PIN ____________________________________

Mother’s Maiden Name ______________________________

E-mail Address _____________________________

E-mail Password ____________________________________

Amazon Username _________________________________

Amazon Password ______________________________________

If you wouldn’t want to make this info public,
you should be taking measures to ensure your online privacy! For example…

  • Security measures in your browser
  • Virtual Private Network (VPN)
  • Anti-virus / malware software
  • Advanced password management (complex passwords, different for each site, two-factor, password manager, etc.)
  • Secure your phone
  • Take steps to avoid tracking
  • Never respond (or even open) Spam mail
  • In general, learn about privacy and security and take it seriously!