Blank Dispute Form
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1DISPUTE FORM
This Form is being provided as a simplified means of communicating legitimate disputes only. By no means should
accurate, valid and verifiable information be disputed.
STEPS TO DISPUTE THE ACCURACY OF ANY ITEM ON YOUR CREDIT REPORT:
PLEASE READ “IMPORTANT INFORMATION”
Fill out this Dispute Form completely; supply photocopies of all proof of payment and/or documentation.
If you dispute information from more than one agency, you must dispute the information directly with them.
If your identifying information differs from the information listed on the credit report. A photocopy of your driver’s license,
social Security card & a recent utility bill will help the Credit Reporting Agency expedite the reinvestigation.
Keep a photocopy of all information mailed to the Credit Reporting Agencies for your records.
PLEASE USE A SEPARATE DISPUTE FORM FOR EACH CREDIT REPORTING AGENCY
Last Name___________________________First Name________________________Middle Initial_________Jr, Sr, II, III, IV
Address______________________________________________Social Security Number
City______________________________________State________Zip Code_____________Date of Birth
Previous Address_______________________________________City________________________State________Zip
DISPUTED ACCOUNT INFORMATION
1. Company Name
3. Company Name
Account #
Account #
Not my account________
Never paid late
Not my account________
Never paid late
Included in Bankruptcy________ Paid in full
Included in Bankruptcy________ Paid in full
Other: (please explain)
Other: (please explain)
2. Company Name
4. Company Name
Account #
Account #
Not my account________
Never paid late
Not my account________
Never paid late
Included in Bankruptcy________ Paid in full
Included in Bankruptcy________ Paid in full
Other: (please explain)
Other: (please explain)
At your request, The Credit Reporting Agency will send the results of the reinvestigation to organizations who have reviewed your
credit report within the past 6 months (12 months for Colorado, New York and Maryland residents) and/or employers who have
required within the past two years. Please list the organization you would like notified, using the space below.
SIGNATURE
DATE
Complete this form & mail to Equifax, For Experian & TransUnion please visit their website to file a dispute online.
Experian
Equifax
TransUnion
Consumer Disputes
PO Box 2002
PO Box 740256
2 Baldwin Place
Allen, TX 75013
Atlanta, GA 30374-0256
PO Box 1000
888-397-3742
By Mail Only
Chester, PA 19022-2000
800-888-4213
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