________________________ Date ________________________ Name ________________________ Address ________________________ City, State, Zip ________________________ Home and Work Phone ________________________ Social Security Number Name of Credit Bureau Address of Credit Bureau City, State, Zip RE: Copy of Credit Report To Whom It May Concern: I, (Your Full Name), request a free copy of my complete credit report. (Pick one) Your credit report was used in the evaluation of my credit worthiness and my reque st for credit was denied. I have enclosed a copy of the letter that I have been denied for credit. This request is in accordance with the Fair Credit Reporting Act, which states I must be provided with a free copy at my request, based on the denial of credit. Your credit report was used in consideration of my application for employment and the evaluation of my credit worthiness. I was denied employment based on the information gathered in the hiring process. I have enclosed a copy of the letter stating that I have been denied employment. This request is in accordance with the Fair Credit Reporting Act, which states I must be provided with a free copy at my request, based on the denial of employment. Your credit report was used in consideration of my app lication for insurance and the evaluation of my credit worthiness. I was denied insurance based on the information gathered during the screening process. I have enclosed a copy of the letter stating that I have been denied insurance. This request is in accordance with the Fair Credit Reporting Act, which states I must be provided with a free copy at my request, based on the denial of insurance. Your credit report was used in consideration of my application for rental housing and the evaluation of my credit worthiness. I was denied housing based on the information during the background process. I have enclosed a copy of the letter stating that I have been denied housing. This request is in accordance with the Fair Credit Reporting Act, which states I must be provided with a free copy at my request, based on the denial of rental housing. I am currently unemployed and will be seeking employment within the next 60 days. This request is in accordance with the Fair Credit Reporting Act, which states that I must
be provided with a free copy at my request, based on being unemployed and seeking employment within 60 days. I believe I have been a victim of credit fraud. This request is in accordance with the Fair Credit Reporting Act, which states I must be provided with a free copy at my request, based on being a victim of credit fraud. I am currently a recipient of public assistance. This request is in accordance with the Fair Credit Reporting Act, which states that I must be provided with a free copy at my req uest, based on being a recipient of public assistance. Please send a free copy to the address provided above. To help insure that the correct report is generated, the following additional information is provided: Date of Birth: ______________________________ Previous names (Aliases, previous marriages, name changes, or name shortenings): ______________________________________________________________________________ __________________________________________________________________ Previous addresses and employers (if you have been at your current address or employment for less than 5 years): ______________________________________________________________________________ __________________________________________________________________ Spouse’s first name (if you are married): ______________________________________ Thank you for your cooperation, Sincerely, Sign you name Print your name Enclose: Letter of Denial (if appropriate)/Copy of Driver’s license/Copy of Current Utility Bill