DATE: ________________________


Free Report Department

P. O. Box 740241

Atlanta, GA 30374–0241

Re:  Request for Credit Report based on denial of Credit

Dear Equifax:

I hereby request a copy of my credit report based upon a denial of credit to me as stated below.  This request is made within 60 days of the denial in accordance with the Federal Fair Credit Reporting Act.

Name of Creditor Denying Credit: _____________________________

Address: _______________________________________________

City, State, Zip: __________________________________________

Date of Denial: __________________________________________

My name, address and phone are below. Please provide the report to me by return mail free of charge.

My Name: ____________________________________________

Address: ____________________________________________

City, State, Zip: _______________________________________

Phone:  ________________    Work Phone:  _________________

With kindest regards, I am

Sincerely yours,



Credit Repair Specific Forms

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