Written Request To Obtain My Credit History Report

WRITTEN REQUEST TO OBTAIN MY CREDIT HISTORY REPORT PLEASE PRINT Name: _______________________________________________________________________________________________________ LAST NAME FIRST NAME INITIAL SUFFIX (Sr, Jr, etc.) Current Address: _______________________________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE PREVIOUS ADDRESS(ES) (within last 5 years) Previous Address: _______________________________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE _______________________________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE Date of Birth: MONTH DAY YEAR Social Security Number:_______________________________ ( OPTIONAL) The name and last 4 digits of a major credit card:_________________________________________________ WERE YOU DENIED CREDIT? NO [ ] YES [ ] BY WHICH INSTITUTION? ___________________________ WHEN?_____________ ================================================================================================== · · · Required are two (2) pieces of personal identification to process your request. (Example: driver's license, bank account statement, gas, phone, electricity or cable bill). If your current address has changed within the last ninety (90) days, a confirmation of address must be attached with your request in order to be processed. (Example: gas, phone, electricity or cable bill, bank account statement, driver's license). You can expect to receive a copy of your personal credit report via regular mail within five (5) to ten (10) days. If you have any further inquiries about delivery, please contact us using the toll-free number of the company you chose. Please note that if any corrections are necessary, you must complete the credit report update form enclosed with the credit report sent to you. This form - Consumer Credit Report Update Form ­ can also be found on-line at any of the web address given to you previously, by the Court. American LegalNet, Inc. www.FormsWorkFlow.com