Sample Form 4844, Request for Terminal Action to Input Identity Theft IndicatorsThis Form 4844 has xxxx placeholders in the form fields for EIN/SSN, Name of Taxpayer, Name Control, Periods, Name of Requester and Telephone no. The words EXPEDITE IDENTITY THEFT - LB&I Case are typed in the top margin of the form. The following fields are filled out as follows:MFT: 30Remarks: Input TC 971 AC 522 under ENMODIdentity Theft Action Code: TC 971 AC 522Miscellaneous Field Input: LBI LBI PNDCLMSecondary Date Field: Tax year of ID theft