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Request For Credit Information

To:

RE: Disclosure of Credit Information

By this letter, I hereby request complete disclosure of my personal credit file as held within your agency records. I request that this disclosure provide the names and addresses of any parties who have received a copy of my credit report, and the names and addresses of any parties who have provided information that is contained in my credit report.

Name:____________________________________

Prior or other Name:_____________________

Address:_________________________________

Prior or other Address:__________________

Driver's License #______ Phone #_________

Dated:

__________________________

(Signature)