Name

Address
Date
Dear Credit Bureau,
This serves to notify you on the inaccurate information on my credit report as per your file. I
have sent this letter via registered mail for purposes of formal escalation in the appropriate
courts of law should the need arise.
Recently, I've been denied in my application for (state type: mortgage, car loan, credit card,
health insurance, employment) in (state name of company). Upon closer look, this was due
to inaccurate information on credit report; mine.
I've been unnecessarily embarrassed by this oversight on your part or maybe your credit
reporter's part. The erroneous information below is not only degrading or defamatory. It has
also damaged my good credit standing, prevented me from having something that I badly
needed, and most of all it has caused too much stress which has affected my health. In
short, the quality of my life has been negatively affected by this inaccurate information on
the credit report which is detailed as follows:
(List details of the inaccurate information here)
(Creditor Agency), Acct. 199-2999-RRR
Your immediate removal of the above cited inaccurate information on my credit report will
be greatly appreciated. I am sure you know that credit reporting laws only allow accurate
information to be reported.
Sincerely,

Item #2: I dispute ABC Financial Services account #4545. This account was not a
charge-off, please delete.
According to Section 611 of the Fair Credit Reporting Act, I am requesting that you
re-investigate those items indicated, and promptly delete any unverifiable, inaccurate,
or outdated information from my credit report.
In addition, I am requesting a description of how the investigation was conducted
along with the name, address, and telephone number of anyone contacted for
information. Furthermore, if there is a change in my credit history resulting
from your investigation, I am requesting that an updated report be sent to those
who received my report, within the last two years for employment purposes, or
within the last one year for any other purpose.
My full name is:_______________________________________________________
My Social Security # is:_________________________________________________
My date of birth is:_____________________________________________________
My home phone number is:______________________________________________
My address is:__________________________ (Ave., St., etc.) APT:____________
City: ______________________________ State:_______ Zip Code:_____________
Please send me an updated copy of my report, and notification that items have been
deleted. I will consider 30 days a reasonable time for your re-verification of
these items.
Thank you for your prompt attention in this matter.
Sincerely,
Signature: ______________________________