Date:_____________________

*****Insert Bureau Address Here*****

RE: Request for Deletions of Inaccurate Credit Information
Name:________________________________________________
Current Address:___________________________________________________________
___________________________________________________________
Social Security Number:___________________________________
Date of Birth:______________________________________
To whom it may concern:
I have received a copy of my credit report and find the following items to be in error. Attached is a
copy of my credit report.
Item and Account Number:______________________________________
Nature of Dispute:_____________________________________________
Item and Account Number:______________________________________
Nature of Dispute:_____________________________________________
Item and Account Number:______________________________________
Nature of Dispute:_____________________________________________
By the provisions of Section 611 of the Fair Credit and Reporting Act of 1970, I demand these items
be deleted from all current and future credit reports. Please forward the names of any individuals
and/or organizations you contacted so I may follow up with them directly.
I shall assume that 30 days constitutes a reasonable time for reverification of these entries.
Through our interpretation of Section 611(a), it is understood that the failure to reverify these items
within 30 days constitutes a reason to promptly drop the information from the credit report.
Pursuant to Section 611(d) of The Fair Credit and Reporting Act, please send notification that these
items have been deleted. Please send an updated credit report to my address that is listed above.
The provisions of section 612 state that there is no charge for this notification.
Very respectfully,
X___________________________________
*****Sign above and remove this line*****