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Fill-in, print and mail this to the address on your credit report. One page for each disputed item.
First, Middle, and Last NameChoose Jr. Sr. I, II, III. Leave blank if not applicable.
Your street address including Apt number if applicable.

Your previous address (if within 2 years.)
 		Where you can be reached for questions.
I am writing to dispute the following information in my file.
The items I dispute also are circled on the attached copy of the report I received.
Financial institution,
company, or court name:
Type of item:
 		Account or identifying
number:
I am disputing this for the following reasons:

I am enclosing copies of the following items to support my claim:

 I am asking that you investigate within 30 days and: 
Comments:

Please send:
  Correction notices to everyone who received my report in the past 6 months.
 A corrected report to any employer who received my report the last 2 years for a job application.
Please send me:
 A written copy of the results
 If a correction is made, a free copy of the corrected report
 Written notice if the item is re-added to the report based on proof from the information provider.
 If I disagree with your findings, I want to write a statement and ask that it be included in all future reports.

____________________________
(Signature)

____________________________
(Date)