This document is a request form to obtain a credit history report. It requests the applicant's personal information such as name, current and previous addresses, date of birth, social insurance number, and credit card information. The applicant must provide two pieces of valid photo identification and proof of current address if it has changed in the last 90 days. Upon submitting this completed form along with the proper identification, the applicant can expect to receive a copy of their personal credit report within 5 to 10 days by regular mail or purchase it online with a credit card.

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