Letter Date

Credit Bureau Name
Credit Bureau Address

To Whom It May Concern:

I was denied credit within the past 30 days by Name of Creditor based on a credit report obtained from your company. Enclosed is a copy of the denial letter. Please send me a copy of my credit report as soon as possible.

Your Name
Your Current Address
Your Previous Address
Your Social Security Number
Your Date of Birth
Your Day and Evening Phone Numbers

I have enclosed copies of my driver’s license and social security card.

Sincerely,

Your Name
Your Address

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