Skimmer Form

Instructions

Please provide as much information as possible to explain why you believe there is a skimmer at the location you are reporting, including photos of the fuel dispensers, your receipt, facility information, and/or other evidence.

If you suspect meter tampering or fuel theft at your facility, contact your licensed service company. If meter tampering has occurred, contact local law enforcement immediately.

Credit card skimmers on gas pumps are used to steal payment card information from customers when they purchase fuel.

Indicate if you are a member of the public, law enforcement, merchant, service technician, FCIC, or a financial institution?
Incident Details
The Date of Incident field is required.
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Was merchant notified?
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Were all pumps checked for skimmers?
Was law enforcement notified?
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Law Enforcement Information
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The Law Enforcement Date of Report field is required.
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Complainant's Information

Do you want to remain anonymous?

If you check "Yes" your complaint will be submitted anonymously, If "No" is selected your contact information will no longer be considered anonymous and your information may be subject to release under the Public Information Act, Chapter 552 of the Texas Government Code.
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Attachments

Include pictures of skimmer(s), fuel dispensers, your receipt, facility information, and/or other evidence.

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