(name of credit reporting agency you are requesting a file from)
(print or type only - check appropriate boxes)

__________Please forward a copy of my personal credit file.

__________Please forward a copy of our joint personal credit file.

_____A check or _____a Money Order is enclosed to cover expenses.

_____I/We were denied credit within the past 30-60 days by: 

_____________________________________________________
(name of firm)

because of information in my/our credit files at your agency. 
(copy of letter enclosed)

I/We understand a copy of my/our credit report will be sent without charge.

Date:__________ Daytime/message phone(___)________________

Full Name______________________________________________

Current Address_________________________________________

Mail Address____________________________________________

City, State, Zip__________________________________________

Previous addresses (past 5 years)____________________________

______________________________________________________

Marital status:______Spouse's full name_______________________

Date of birth__________ Spouse_____________________________

Your Social Security #_____________________________________