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Our reference - The Credit Agency UK

EXPERIAN LIMITED FINANCIAL CONNECTIONS QUESTIONNAIRE Please answer the following questions so that we can consider your request to remove your financial link

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Text of Our reference - The Credit Agency UK

EXPERIAN LIMITED FINANCIAL CONNECTIONS QUESTIONNAIREPlease answer the following questions so that we can consider your request to remove your financial link(association) to another person. We call this process disassociation . You should use a separate form foreach person you want to disassociate reference (printed on the top-left-hand side of your credit report) : ..............................STEP ONE - PLEASE COMPLETE THE FOLLOWING DETAILS ABOUT forenameMiddle nameSurnameDate of birthAny other names that you have been known by:Your full current address, including postcode:How long you have lived at this address:Your previous addresses in the last 6 years (please attach an additional sheet if necessary):STEP TWO - PLEASE COMPLETE THE FOLLOWING DETAILS ABOUT THE PERSON YOU WANT TO DISASSOCIATE forenameMiddle nameSurnameDate of birthAny other names that this person has been known by:What is this person's relationship to you?:Their current address :Please provide all the addresses that you have shared with this person in the last 6 years:EXPERIAN LIMITEDSTEP THREE - PLEASE COMPLETE AND SIGN THE DECLARATION BELOWI confirm that the information provided on this form is correct and I understand that failure to complete thisform or any attempt to misrepresent information may result in your request being refused. The person referred to and I: (please tick all the boxes that apply)do NOT share a bank accountdo NOT share a mortgage in joint names (includingany outstanding liability under a mortgage agreement)have NO shared joint credit agreements have NO other shared financial linkdo NOT live at the same address If any of the above boxes have NOT been ticked, please explain why you believe you should nolonger be considered as being financially linked, so that we can assess your circumstances fully:I/we confirm that there is no active financial connection or dependency between myself andthe person detailed above. I/we understand that if I make a false statement and, as a result, obtain finance that I/wemight not otherwise have obtained, I may be guilty of a criminal also understand that Experian may verify the details I have given against their ownrecords and, in some cases, may need to request further information to support signature:.............................. ............................Date:....... ........................................ ...........Signature of the person you wish to disassociate from:................................... ...................(If you are unable to provide this, please see below)Date:............................. .............................If the person you wish to disassociate from has not signed the form, please explain why in the box below:When you have completed this form, please return it to:EXPERIAN CONSUMER HELP SERVICE, PO BOX 9000, NOTTINGHAM, NG80 7WP