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Equifa

Research Request Form You may initiate an investigation request via the internet at www.investigate.equifax.com. Or, mail this document to the following address:

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Text of Equifa

Research Request FormYou may initiate an investigation request via the internet at , mail this document to the following address:Equifax Information Services LLC Box 740256Atlanta, GA 30348Email Address (please print clearly):*Please provide your email address if you would like to be informed once your reinvestigation is completed and if you would like to view the results ofyour reinvestigation you like Equifax to hide the first 5 digits of your social security number on our response to you? Circle: Yes NoConfirmation Number (please provide if you have a confirmation number):Intentionally making any false statements to a consumer reporting agency for the purpose of having it placed on a consumer report is punishable by law in some states. To ensure that your request is processed accurately, please enlarge photocopies of any items that contain small print ( driver s license, W2 forms, etc.). Photocopies that are not legible or contain highlighting may cause us to request that you resubmit your request for clarity. If your identity information differs from the information listed on this form, please fill in the correct information in the space provided for each item. Please provide a photocopy of your driver s license, social security card, or recent utility bill that reflects the correct Information Name Social Security Number Date of Birth Current Address Previous Address(es) Daytime Phone Number Evening Phone Number List other names which you have used in the past Account Information Company Name Account Number Reason for investigation: Not Mine Paid in Full Current/Previous Status Incorrect Account Closed Other (Please explain) Company Name Account Number Reason for investigation: Not Mine Paid in Full Current/Previous Status Incorrect Account Closed Other (Please explain) Company Name Account Number Reason for investigation: Not Mine Paid in Full Current/Previous Status Incorrect Account Closed Other (Please explain) Equifax