Application

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Application

APPLICATION

Welcome

To Start the healing process we will need a list of all your fraudulent items and unauthorized purchases from your credit report.

In the boxes below we will need: name of furnisher, date opened and status amount.

Example:

1. Name of furnisher: Captital

Date opened: 12/20/21

Balances: 70,000.00

Status amount: 70,000.00

2. Name of furnisher: Captital

Date opened: 12/20/21

Balances: 70,000.00

Status amount: 70,000.00

3. Name of furnisher: Captital

Date opened: 12/20/21

Balances: 70,000.00

Status amount: 70,000.00

Name *

First

Middle

Last

Date of Birth *

Social Security No.

Address *

City - State - zip code *

Phone Number

Email *

EXPERIAN : NUMBER EACH FRAUDULENT ITEMS IN BOX BELOW

EXPERIAN

Name

First

Middle

Last

TransUnion: NUMBER EACH FRAUDULENT ITEMS IN BOX BELOW

LIST ALL FRAUDULENT ITEMS IN BOXES BELOW

TransUnion

Name

First

Middle

Last

EQUIFAX: NUMBER EACH FRAUDULENT ITEMS IN BOX BELOW

EQUIFAX

INQUIRY REMOVAL: Fraudulent and Unauthorized Inguiries

Unknown inquiries does effect your credit scores you should take ANY incorrect inquiries on your credit report seriously. Unfamiliar inquiries on your credit report could be a sign of Identity Theft. Unfamiliar inquiries on your credit report could be a sign of Identity Theft. In the boxes below list all fraudulent and unauthorized inquiries that you do not RECALL making.

Numbered Fraudulent and Unauthorized Inquiries

FREE WRONG NAME AND ADDRESS REMOVAL

While your name and address does not effect your credit score, you should take ANY incorrect identitying information on you credit report seriously. Unfamiliar names and address on your credit report could be a sign of Identy Theft.

Number Each Wrong Name and Address In Box Below

HOW DID YOU HEAR ABOUT US?

Agent Name

Payment Center

* Please do not remit tax deductible payment until after consultation or confirmation of your application.

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