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Run: Elder Financial Exploitation Red Flag Report Form

Document suspected elder financial exploitation red flags, the customer context, and the actions taken so the case can be routed for review with a clear audi...

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Submission Notice

Purpose of this report

Your name (required)

Your role (required)

Best internal contact number or email (required)

Use an internal work contact so reviewers can follow up if needed.

Date of report (required)

Customer and Account Context

Customer name (required)

Customer age range (required)

Account identifier or last 4 digits (required)

Do not enter full account numbers if not required by your internal process.

Where was the concern observed? (required)

Date observed (required)

Observed Red Flags

Behavioral red flags observed (required)

Transactional red flags observed (required)

Was a third party involved? (required)

Third party relationship, if known

Describe any coercion, pressure, or unusual instructions

Estimated transaction amount

Enter the approximate amount if known; do not guess.

Actions Taken

Was the customer spoken with privately? (required)

Customer's explanation for the activity

Record the customer's words as accurately as possible.

Actions taken by staff (required)

Is there immediate risk of harm or loss? (required)

Follow-up required (required)

Attachments and Certification

Supporting documents

Upload only documents allowed by policy, such as notes, screenshots, or transaction references. Avoid unnecessary PII.

Attestation (required)

Yes No N/A

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Email (required)

Your name (optional)

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