CREDIT REPORT DISPUTE FORM

CREDIT REPORT DISPUTE FORM TRANS UNION Consumer Relations Center PO Box 390 Springfield PA 19064-0390 EQUIFAX CREDIT INFORMATION SERVICE P.O. Box 105873 Atlanta, GA 30348 EXPERIAN National Consumer Assistance Center PO Box 949 Allen, TX 75002-0949 Name _________________________________________________ Date of Birth _________________________ Address _______________________________________________ Home Phone __________________________ _______________________________________________Work Phone ________________________ Social Security Number ______________________________________________ I dispute the accuracy or completeness of the following items that appear in my file: Signature __________________________________________________________ Date _____________________ Company name _____________________________ Account # ______________________ ____________________________________ Comments ____________________________________ ____________________________________ _____________________________ ______________________ ____________________________________ ____________________________________ ____________________________________ _____________________________ ______________________ ____________________________________ ____________________________________ ____________________________________ _____________________________ ______________________ ____________________________________ ____________________________________ ____________________________________ Thank you for your assistance in investigating the accuracy of this information.

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