CONSUMER DISPUTE AND STATEMENT

(See Test Section 611 – Procedure in Case of Disputed Accuracy)

ATTENTION: ___________________________________________________________

          (Name of Credit Reporting Firm)

I Dispute the completeness and/or accuracy of my credit file as revealed to me on ___________________(Date)

In accordance with Section 611 of the Fair Credit Reporting Act, I hereby request that you re-investigate and record the current status of the information I have disputed below in paragraph 1.

If your re-investigation does not resolve the dispute, I hereby file the statement below in paragraph 2 which shall be included in any subsequent consumer report containing the information in question.

1.     The disputed portion reads:________________________________________________

_________________________________________________________________________

_________________________________________________________________________

2.     I maintain that: __________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

  (This section may be limited to 100 words if the reporting firm assists in writing the summary)

_______________________________          ____________________

(Name in Print)                                               (Date)

_________________________________________________

     (Signature)

_________________________________________________

       (Street Number and Name)

_________________________________________________

      (City, State, Zip)

 (________________)-(___________)-(________________)

          (Social Security Number)

NOTE: I HAVE INCLUDED A COPY OF MY DRIVER'S LICENSE AND MY SOCIAL SECURITY CARD ALONG WITH A VOIDED CHECK TO PROVE MY ADDRESS AND THE AUTHENTICITY OF THIS DISPUTE.