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    4. authorization to release credit information

    Authorization to Release Credit Information

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    AUTHORIZATION TO RELEASE CREDIT INFORMATION

     

    Date:             ___________________________________

    To:                ___________________________________

    Account #:     ___________________________________



    As a holder of the above referenced credit account with your firm, I (we) hereby authorize and request that a report detailing my (our) credit history with your firm be forwarded to the following companies and/or credit reporting agencies listed at the bottom of this page.  Please be advised, this letter serves as my (our) authorization for the release of my (our) credit history information with your firm.  Thank you for your cooperation in this matter.


    ___________________________________    ___________________________________
    Signature                                                    Signature of Joint Applicant (if any)

    ___________________________________    ___________________________________
    Social Security Number                               Social Security Number

    ___________________________________    _____________________________________
    Address, Line 1                                           Address, Line 1

    ___________________________________    _____________________________________
    Address, Line 2                                           Address, Line 2
     

    Credit Reporting Agencies/Companies:

     
    ___________________________________    _____________________________________
    Agency/Company                                        Agency/Company

    ___________________________________    _____________________________________
    ATTN                                                          A
    TTN

     ___________________________________    _____________________________________
    Address, Line 1                                           Address, Line 1

    ___________________________________    _____________________________________
    Address, Line 2                                           Address, Line 2
     


    ___________________________________    _____________________________________
    Agency/Company                                        Agency/Company 

    ___________________________________    _____________________________________
    ATTN                                                          A
    TTN

    ___________________________________    _____________________________________
    Address, Line 1                                           Address, Line 1 

    ___________________________________    _____________________________________
    Address, Line 2                                           Address, Line 2


    Other Forms You May Need

    • Letter Requesting Authorization to Release Credit Information
    • Disputed Account Settlement

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