CREDIT REPORT PERSONAL

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PREVIOUS ADDRESS
SPOUSE/CO-APPLICANT /CO-OWNER
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In order to purchase and obtain a copy of your credit report on yourself you must fill out this form and print it out, sign and date it and fax or email it back to us with a copy of your Drivers license for verification. Our fax number is 718-795- 1646 or our email address is creditreport@usbackgroundsearch.com. You must have a valid phone number where you can be contacted at.

I authorize and agree to allow US Background Search to access my credit file from the major credit bureaus and to fax, email or send by regular mail my credit report as requested.

Authorized Signature___________________ Date ______________

Spouse/CO-Applicant________________________ Date ______________

If you are requesting a copy of someone else's credit report. You must fill out the request form and have that person sign and date the form and send back to us along with a copy of their Drivers License as well as yours. You must have a valid phone where you can be contacted at.
Name of Person requesting report if other than true applicant.

LAST NAME_____________________ FIRST NAME_____________________ MIDDLE____________SUFFIX______

COMPANY NAME_____________________

STREET ADDRESS/P.O. BOX_____________________ APT/SUITE___________

CITY__________________ STATE________________ZIP____________

PHONE NUMBER_____________________

Authorized Signature___________________ Date ______________

BY SUBMITTING THIS SEARCH, YOU AGREE TO ALL OF OUR TERMS & CONDITIONS.