Purpose of this form
 
Credit account holder authorizes the release of his/her credit history and information to other specified companies and credit reporting agencies 

Used when applying for a loan, mortgage, credit card or starting a business on credit

Making one's good credit known to credit agencies improve one's credit rating
Date:             ___________________________________

To:                ___________________________________

Account #:     ___________________________________

As a holder of the above referenced credit account with your firm, I (we) hereby authorize and request that a report detailing my (our) credit history with your firm be forwarded to the following companies and/or credit reporting agencies listed at the bottom of this page.  Please be advised, this letter serves as my (our) authorization for the release of my (our) credit history information with your firm.  Thank you for your cooperation in this matter.

___________________________________    ___________________________________
Signature                                                    Signature of Joint Applicant (if any)

___________________________________    ___________________________________
Social Security Number                               Social Security Number

___________________________________    _____________________________________
Address, Line 1                                           Address, Line 1

___________________________________    _____________________________________
Address, Line 2                                           Address, Line 2
 

Credit Reporting Agencies/Companies:

 
___________________________________    _____________________________________
Agency/Company                                        Agency/Company

___________________________________    _____________________________________
ATTN                                                          ATTN

 ___________________________________    _____________________________________
Address, Line 1                                           Address, Line 1

___________________________________    _____________________________________
Address, Line 2                                           Address, Line 2
 

___________________________________    _____________________________________
Agency/Company                                        Agency/Company

___________________________________    _____________________________________
ATTN                                                          ATTN

___________________________________    _____________________________________
Address, Line 1                                           Address, Line 1

___________________________________    _____________________________________
Address, Line 2                                           Address, Line 2

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