CREDIT REPORT ORDER FORM
Please print clearly. Provide all requested information. Proof of identity, such as a copy of your driver’s license, must be presented before a report can be pulled. Check all that apply: Experian Credit Report .................................................................... $ 12.00 add CreditXpert Score Analysis..................................................... $ 4.50 Equifax Credit Report....................................................................... $ 15.00 add CreditXpert Score Analysis..................................................... $ 4.50 TransUnion Credit Report ............................................................... $ 15.00 add CreditXpert Score Analysis..................................................... $ 4.50 3 Bureau Report ................................................................................ $ 32.00 add Experian CreditXpert Score Analysis ..................................... $ 4.50 add Equifax CreditXpert Score Analysis ....................................... $ 4.50 add TransUnion CreditXpert Score Analysis ................................ $ 4.50
Full Name: ____________________________________________________________________________
(Last) (First) (MI) (Jr., Sr., II, III) (Former/Maiden, etc.)
Current Address: ______________________________________________________________________ Previous Address: ______________________________________________________________________
(If you have been at your current address less than 2 years)
City: _____________________________ SSN: ______________________
State: ______________
Zip: ________________________
DOB: ______________
Home Phone: (_______)_______________
I understand that I am providing written instructions to Consumer Financial Solutions under the Fair Credit Reporting Act authorizing Consumer Financial Solutions to obtain information from my personal credit profile. I authorize Consumer Financial Solutions to obtain such information solely to provide me with a Consumer Credit Report. Under the Fair Credit Reporting Act any person who knowingly and willfully obtains credit information from a consumer reporting agency under false pretenses or violates any of the provisions of the FCRA may be liable for civil penalty. By signing below, I certify that I am the person named above and that I am authorizing this request to receive my consumer credit report for my personal review. The information provided in this statement is true and correct to the best of my knowledge. I agree to hold Consumer Financial Solutions, its employees, officers, and agents harmless from any claim, suit, action, or demand by myself or any other person arising from the credit report provided.
Signature: ______________________________________________________ Date: _________________
1090 N Cole Rd Boise, Idaho 83704 ph. 208.375.8140 fax. 208.375.8163 www.cfsidaho.com information@cfsidaho.com