Credit Report Inaccuracy Dispute Form

Instructions:

  1. Fill in the following fields and then print this form.
  2. Sign and mail this form to the appropriate credit bureau(s) along with copies of any pertinent paperwork.
  3. Keep a copy for your records.

Date: / /

First:    Middle:    Last:  Suffix:

Current Address:

City:   State: Zip:

Social Security Number: – –                   Date of Birth: / /

Information to Dispute:

Creditor:

Account Number:

Reason for Dispute:

__________________________________
Signature

Mail To:

    Equifax Information Services
    P.O. Box 740256
    Atlanta, GA 30374

    Trans Union Corporation
    P.O. Box 390
    Springfield, PA 19064

    Experian
    National Consumer Assistance Center
    P.O. Box 2002
    Allen, TX 75013

THIS FORM IS PROVIDED AS A SERVICE BY THE CREDIT REPORT SITE
© 1999 The Credit Report Site at www.thecreditreportsite.com