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