Credit Report Dispute Form

If you feel there are inaccuracies in your Credit Report, you must write directly to First Advantage Consumer Disputes. First, fill out the info on
below. Print the name and account number of the creditor in ques on in the Account Name/Number fields. Also, clearly print the specific reason
for your dispute. Finally, sign the form in the space marked Signature and submit the en re form to:

First Advantage Consumer Disputes

12395 First American Way
Poway CA 92064
We also recommend ng directly to the credit (bank, department store, or other lender) detailing the inaccuracy.

First Name Middle Last

Jr. Sr. Date of Birth (MM/DD/YYYY) / /
Address:
City State Zip

Social Security Number (necessary to access your Credit Report) - -

Signature *Membership Number

Account Name Account Number

Dispute Reason:
Not Mine Late Payments
Paid In Full Balance (Provide Approx Balance)
Other

Account Name Account Number

Dispute Reason:
Not Mine Late Payments
Paid In Full Balance (Provide Approx Balance)
Other

Account Name Account Number

Dispute Reason:
Not Mine Late Payments
Paid In Full Balance (Provide Approx Balance)
Other

Account Name Account Number

Dispute Reason:
Not Mine Late Payments
Paid In Full Balance (Provide Approx Balance)
Other

*Membership number can be found on the My Account page of the website.