Applicant Disclosure And Release Form - Diocese Of Fort Wayne-South Bend Page 3

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California, Minnesota, and Oklahoma residents only:
Please initial here only if you are requesting a copy of the consumer report prepared on you ___________.
Para informacion en espanol, visite
o escribe a la Consumer
Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20552.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of
information in the files of consumer reporting agencies. There are many types of consumer reporting
agencies, including credit bureaus and specialty agencies (such as agencies that sell information about
check writing histories, medical records, and rental history records). Here is a summary of your major
rights under the FCRA. For more information, including information about additional rights, go to
or write to: Consumer Financial Protection Bureau, 1700 G
Street N.W., Washington, DC 20552.
You must be told if information in your file has been used against you. Anyone who uses a credit
report or another type of consumer report to deny your application for credit, insurance, or employment
– or to take another adverse action against you – must tell you, and must give you the name, address,
and phone number of the agency that provided the information.
You have the right to know what is in your file. You may request and obtain all the information about
you in the files of a consumer reporting agency (your “file disclosure”). You will be required to provide
proper identification, which may include your Social Security number. In many cases, the disclosure will
be free. You are entitled to a free file disclosure if:
a person has taken adverse action against you because of information in your credit report;
you are the victim of identity theft and place a fraud alert in your file;
your file contains inaccurate information as a result of fraud;
you are on public assistance;
you are unemployed but expect to apply for employment within 60 days.
In addition, all consumers are entitled to one free disclosure every 12 months upon request from each
nationwide credit bureau and from nationwide specialty consumer reporting agencies. See
for additional information.
You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-
worthiness based on information from credit bureaus. You may request a credit score from consumer
reporting agencies that create scores or distribute scores used in residential real property loans, but
you will have to pay for it. In some mortgage transactions, you will receive credit score information for
free from the mortgage lender.
You have the right to dispute incomplete or inaccurate information. If you identify information in
your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency
must investigate unless your dispute is frivolous. See
for an
explanation of dispute procedures.
Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable
information. Inaccurate, incomplete or unverifiable information must be removed or corrected,
usually within 30 days. However, a consumer reporting agency may continue to report information
it has verified as accurate.
Consumer reporting agencies may not report outdated negative information. In most cases, a
consumer reporting agency may not report negative information that is more than seven years old, or
bankruptcies that are more than 10 years old.
Access to your file is limited. A consumer reporting agency may provide information about you only
to people with a valid need -- usually to consider an application with a creditor, insurer, employer,
landlord, or other business. The FCRA specifies those with a valid need for access.
You must give your consent for reports to be provided to employers. A consumer reporting agency
may not give out information about you to your employer, or a potential employer, without your written
consent given to the employer. Written consent generally is not required in the trucking industry. For
more information, go to .
You may limit “prescreened” offers of credit and insurance you get based on information in your
credit report. Unsolicited “prescreened” offers for credit and insurance must include a toll-free phone

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