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REQUEST TO OBTAIN MY CREDIT HISTORY REPORT

PLEASE PRINT
Name:             __________________________________________________________________
                   LAST NAME                 FIRST NAME            INITIAL              SUFFIX (Sr, Jr, etc.)

Current Address:    ________________________________________________________________________________
                    STREET ADDRESS          APT.    CITY              PROVINCE         POSTAL CODE


PREVIOUS ADDRESS(ES) (within last 5 years)
Previous Address:
___________________________________________________________________________________________________
STREET ADDRESS                     APT.    CITY                      PROVINCE         POSTAL CODE


___________________________________________________________________________________________________
STREET ADDRESS                     APT.    CITY                      PROVINCE         POSTAL CODE

Date of Birth:                                                           Social Insurance Number:
________/______/_______                                                  _____________________________
MONTH / DAY / YEAR                                                                (OPTIONAL)

The name and last 4 digits of a major credit card:        ____________________________________________

WERE YOU DENIED CREDIT?
NO [ ] YES [ ] BY WHICH INSTITUTION? _______________________________ WHEN? ______________________


_______________________________________________                 _______________________________________
SIGNATURE                                                       Date




* They will require two (2) pieces of personal identification (BOTH SIDES – 1 photo) to
process your request. (eg: driver’s license, prov. ID card, prov. Health care card, SIN card).
If your current address has changed within the last 90 days, a confirmation of address
must be attached with your request in order to be processed. (eg: gas, phone, electricity
or cable bill, bank account statement, driver’s license).

** You can expect to receive a copy of your personal credit report via regular mail within 5
to 10 days. You can purchase your reports online for a fee if you have a visa or m/c.


Forward by Mail or Fax to both of the following:

         Equifax                                                         TransUnion
         National Consumer Relations                                     Consumer Relations
         P.O. Box 190, Station Jean-Talon,                               P.O. Box 338 L.C.D.I.
         Montreal, Quebec                                                Hamilton, Ontario
         H1S 2Z2                                                         L8L 7W2
         Fax: (514) 355-8502                                             Fax: (905)527-2360

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Credit report request form

  • 1. REQUEST TO OBTAIN MY CREDIT HISTORY REPORT PLEASE PRINT Name: __________________________________________________________________ LAST NAME FIRST NAME INITIAL SUFFIX (Sr, Jr, etc.) Current Address: ________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE PREVIOUS ADDRESS(ES) (within last 5 years) Previous Address: ___________________________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE ___________________________________________________________________________________________________ STREET ADDRESS APT. CITY PROVINCE POSTAL CODE Date of Birth: Social Insurance Number: ________/______/_______ _____________________________ MONTH / DAY / YEAR (OPTIONAL) The name and last 4 digits of a major credit card: ____________________________________________ WERE YOU DENIED CREDIT? NO [ ] YES [ ] BY WHICH INSTITUTION? _______________________________ WHEN? ______________________ _______________________________________________ _______________________________________ SIGNATURE Date * They will require two (2) pieces of personal identification (BOTH SIDES – 1 photo) to process your request. (eg: driver’s license, prov. ID card, prov. Health care card, SIN card). If your current address has changed within the last 90 days, a confirmation of address must be attached with your request in order to be processed. (eg: gas, phone, electricity or cable bill, bank account statement, driver’s license). ** You can expect to receive a copy of your personal credit report via regular mail within 5 to 10 days. You can purchase your reports online for a fee if you have a visa or m/c. Forward by Mail or Fax to both of the following: Equifax TransUnion National Consumer Relations Consumer Relations P.O. Box 190, Station Jean-Talon, P.O. Box 338 L.C.D.I. Montreal, Quebec Hamilton, Ontario H1S 2Z2 L8L 7W2 Fax: (514) 355-8502 Fax: (905)527-2360