Georgia Resident Bi Annual Credit Report Request Form If you

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Georgia Resident Bi-Annual Credit Report Request Form If you are a resident of the State of Georgia, you have the right under state law to obtain two (2) free copies of your credit file disclosure, com m only called a credit report, during each calendar year, from each of the three nationwide consum er credit reporting com panies - Equifax, Experian and TransUnion. This is NOT a request under the FACT Act Amendment to the Fair Credit Reporting Act. In order to exercise your right under Georgia Law to obtain a free copy of your report, you should print clearly and provide the information below, then mail this form to the appropriate agency at the following addresses: Equifax Information Services LLC - PO Box 740241 - Atlanta, GA 30374 Experian - PO Box 9600 - Allen, TX 75013 TransUnion LLC - PO Box 1000 - Chester, PA 19022 Social Security Number : _________________________________________________ Date of Birth (MM/DD/YYYY) : ___________________________________________ First Name: __________________________ Middle Initial : __________ Last Name: _________________________________ Suffix ( Jr., Sr., etc.) : ___________ Current Mailing address: House Number: _________ Street Name: _______________________________________ Apartment Number, if any: _______________________ City: __________________________________ State: _______ Zip: ___________________ Previous Mailing Address (only if at current mailing address for less than two years): House Number: ________ Street Name: ________________________________________ Apartment Number, if any: ______________________ City: __________________________________ State: _______ Zip: ___________________ I hereby m ake this request for disclosure of m y credit report under the laws of the State of Georgia, and state that I am eligible to receive this free report. I understand that obtaining a credit report under false pretenses is a federal crim e. Please m ail the inform ation to m e at the above stated current m ailing address. If additional inform ation is needed to process this request, please contact m e by m ail. ___________________________________ Signature _________________________________ Date

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