Credit Reporting Agency/Bureau Consumer Statement for Disputed Items

[Date]

Credit Reporting Agency/Bureau

City, State, Zip

RE:   CONSUMER STATEMENT FOR DISPUTED ITEMS

To Whom It May Concern:

According to the Fair Credit Reporting Act, § 611(b) [USC 15 1681i(b)], I am entitled to “file a statement setting forth the nature of the dispute.” I would like potential future creditors to be aware of the dispute, and want the following statement included in my credit report.

[Consumer statement---100 words or less]

I am requesting an updated copy of my credit report, which should be sent to the address listed below. According to the provisions of  § 612 [15 USC § 1681j], there should be no charge for this report.

If you have any questions or need additional information, please contact me at (XXX) XXX-XXXX.

Thank you.

Sincerely,

Bruce Smith

Address

City, State, Zip

Social Security #