Sample Credit Dispute Letter
Name: Last__________________ First ________________Middle ____________
Current Address_______________________________________________________
Former Address_______________________________________________________
Social Security #________________________ Home Phone____________________
Date of Birth___________________________ Work Phone_____________________
Employer_____________________________
Credit Report Dispute / Account Information Dispute Section
Company Name__________________________
Account #__________________________
__ Not my account __ Was never late __Account paid in full
__ Current status incorrect __ Other __Dispute
Explanation________________________________________________________________
Company Name__________________________ Account #__________________________
__ Not my account __ Was never late __Account paid in full
__ Current status incorrect __ Other __Dispute
Explanation________________________________________________________________
Company Name__________________________ Account #__________________________
__ Not my account __ Was never late __Account paid in full
__ Current status incorrect __ Other __Dispute
Explanation________________________________________________________________
Company Name__________________________ Account #__________________________
__ Not my account __ Was never late __Account paid in full
__ Current status incorrect __ Other __Dispute
Explanation________________________________________________________________
Courthouse or Collection Agency accounts
Courthouse or Collections agency_______________________________________________
Case number for courthouse records only_________________________________________
__ Not Mine (explain) __ Satisfied __ Released __ Dismissed
__ Discharged __ Collection was paid __ Other (explain)
Explanation________________________________________________________________
Courthouse or Collections agency_______________________________________________
Case number for courthouse records only_________________________________________
__ Not Mine (explain) __ Satisfied __ Released __ Dismissed
__ Discharged __ Collection was paid __ Other (explain)
Explanation________________________________________________________________
I certify that all information above is true and factual.
Signature ____________________________________________ date __________________
