On [Date], [Elder’s Name] conducted a transaction at the [Branch/Channel] involving $[Amount] by way of [cash withdrawal, wire transfer, cashier’s check, debit, etc.]. The transaction was unusual compared to the member’s typical account activity, which generally consists of [describe: pension deposits, small ATM withdrawals, bill payments, etc.].

The elder was accompanied by [Individual’s Name/“unidentified person” if unknown], who [provided instructions, insisted on urgency, refused to let elder speak alone, etc.]. Staff observed that the elder appeared [confused, hesitant, fearful, or stated they were instructed to withdraw funds].

Pattern of Concern (if applicable):
Between [Date] and [Date], the account reflects:

• [Date] – $[ ] [transaction type]

• [Date] – $[ ] [transaction type]

• [Continue if more than one incident]

When staff asked about the purpose of the withdrawal on [Date], the elder stated: “[Insert exact wording if available].” This explanation was inconsistent with known account history and raised concerns of possible exploitation.

Attempts to contact the elder privately at [phone/address] were [unsuccessful/successful with concerning statements]. The suspected exploiter, [Name if known], has no relationship on file with the financial institution and is not a joint account holder.

SAR Template Elder Financial Exploitation