Fill and Sign the Consumer Rights Form

Result of Investigation of Disputed Credit Information and Disclosure of Consumer Rights in Event of Continued Dispute File No.:___________________________ Date: ______________________________________ To: ____________________________________________ (Name of consumer) ________________________________________________________________________ (Address of consumer) We have completed our investigation of the items in your credit profile which you have disputed. As a result of this investigation, the changes listed in the column headed "Revised Status" (below) have been made in your credit profile . SEE REVERSE SIDE OF THIS FORM FOR YOUR RIGHTS IN CASE OF DISPUTE. Name of reporting company & acct. no./or name of court & docket no. Date Reported Date Opened Current status and if litigation, plaintiff REVISED STATUS (Specify) (Date) (Date) (Specify) (Describe) (Specify) (Date) (Date) (Specify) (Describe) (Specify) (Date) (Date) (Specify) (Describe) As you requested, we are also taking action to mail a copy of this letter to the following companies who have received a copy of your credit profile during the preceding one year or, for employment purposes, during the past two years. Name of Company Address Date of Credit Inquiry (name of company) (address of company) (date) (name of company) (address of company) (date) (name of company) (address of company) (date) (To Be Printed on Reverse Side) These mailings will be made without charge to you in the event that any changes in your credit profile are made. In addition, if any items of information are deleted because they are inaccurate or unverifiable, and you may have previously paid us a file review charge, we will refund $ _________________ to you. If you continue to dispute the accuracy, you may call our office or make an appointment for a personal visit with one of our consumer relations representatives. We will assist you in preparing a summary of your version of the dispute for notation on your profile. This summary will be made available to all future recipients of your credit profile, and __________________________ _________________ (name of consumer reporting agency) will, at your request, supply a copy of your credit profile showing the dispute to those companies that have received a copy of your profile during the preceding one year or, for employment purposes, during the preceding two years. We thank you for your assistance and apologize for any inconvenience you may have experienced. We appreciate having the opportunity of being of service to you in this matter. __________________________________________ ( Name of Consumer Reporting Agency) By: ______________________________________ __________________________________________ Signature & Name of Office or Position Date: _________________________________