Authorization to Release Credit Information

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					This is a form whereby an individual or entity grants permission to a third party to obtain
information related to credit reports from a creditor or credit bureau. The form also
provides that the credit bureau shall be held harmless from any liability arising from
providing accurate credit reports to the authorized individual or entity. This form should
be used by individuals or entities who wish to grant permission to a third party to check
their credit history.
   AUTHORIZATION TO RELEASE CREDIT INFORMATION

Date: ________________, 201___

To:

____________________________

____________________________[NAME AND ADDRESS OF CREDIT REPORTING
AGENCY]


RE: My Credit Report

I hereby authorize and request that a credit report detailing my credit history with your firm be
released to ____________________ [NAME OF PERSON OR NAME OF OFFICE AT THE
PLACE THAT WILL BE RECEIVING THE CREDIT REPORT] of
_________________________________________ _________________. [NAME AND
ADDRESS OF COMPANY OR PLACE THAT WILL BE RECEIVING THE REPORT.]

This letter serves as my authorization for the release of my credit history with your firm. I agree
to hold you harmless from any liability arising out of providing my accurate credit reports to the
above person/organization, at the above address.

This authorization shall remain in effect for a period of thirty (30) days from the date entered
below.

Thank you for your cooperation on this matter.


Date:_______________________, 201___


Signed:_______________________________________________________

Print Name:____________________________________________________

Social Security Number:______________________________________

Credit Account Number: _____________________________________

Address:____________________________________________________

______________________________________________________ [ADDRESS                        OF THE
PERSON WHO IS REQUESTING HIS OR HER CREDIT                                             REPORT]

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DOCUMENT INFO
Description: This is a form whereby an individual or entity grants permission to a third party to obtain information related to credit reports from a creditor or credit bureau. The form also provides that the credit bureau shall be held harmless from any liability arising from providing accurate credit reports to the authorized individual or entity. This form should be used by individuals or entities who wish to grant permission to a third party to check their credit history.
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