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CREDIT REPORT FORM
FAX #: (250) 344-2117
MEMBER NAME(S): SOCIAL INSURANCE NUMBER(S):
FIRST & LAST
STREET ADDRESS: ARE YOU CURRENTLY WORKING?
YES NO
MAILING ADDRESS: DATE(S) OF BIRTH: YOUR EMPLOYER:
DAY / MONTH / YEAR
CITY: PROVINCE: YOUR CONTACT NUMBER:
British Columbia
I/We hereby consent to Columbia Valley Credit Union obtaining a credit information report on me from a
consumer reporting agency.
NOTE: This consent also allows information on a spouse to be included in any report.
Please fax the completed form to 250 344-2117.
SIGNATURES
_________________________________________ _____________________
SIGNATURE DATE SIGNED
_________________________________________ _____________________
SIGNATURE DATE SIGNED