I authorize __________________ to provide ___[insert attorney’s name, attorney’s company’s
name, if appropriate, and attorney’s relationship to signatory] all of the following documents in
Applications for Credit Monthly Statements
Adverse Action Notices Correspondence (of any kind)
Universal Data Forms (UDF) Automated Universal Data Forms (AUDF)
Requests for Investigations of Credit Data Results of Investigations of Credit Data
Consumer Dispute Verification Forms (CDV) Credit Reports
Automated Consumer Dispute Verification Forms Payments/Payment History
Account Reviews Credit Denial Determinations
for the following accounts:
I also authorize ________________ to directly discuss the above account(s) with _____[insert
attorney’s name and, if appropriate, attorney’s company’s name]___. This authorization shall
expire on ________________.
YOU MAY ACCEPT A COPY OF THIS DOCUMENT IN LIEU OF THE ORIGINAL.
County/City of ____________________________
State of __________________.
On this ____ day of _________________, 2008, _______________________________
personally appeared before me and acknowledged that he/she executed the foregoing instrument.
My commission expires on ________________________