SECURITY FREEZE REQUEST
Submitted pursuant to the Fair Credit Reporting Act, 15 U.S.C. § 1681c-1, and applicable state security freeze statutes.
________
________
Telephone: ________
Email: ________
Date: ________
TO:
Equifax Information Services LLC
Equifax Security Freeze
P.O. Box 105788
Atlanta, GA 30348
Sent via: ________
Re: Request to Place a Security Freeze on Consumer Credit File
Dear Equifax,
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§ 2. Identifying Information. To enable you to identify my file and process this request, I provide the following information:
- Full legal name: ________
- Any other names previously used: ________
- Social Security Number: ________
- Date of birth: ________
§ 3. Current Address. My current address is:
________
I have resided at this address since ________.
§ 4. Prior Address. If I have resided at my current address for less than two (2) years, my immediately preceding address is:
________
§ 5. Proof of Identity and Residence. As required for verification of identity, I enclose with this request legible copies of the following supporting documents:
- Proof of identity: a copy of my ________, identification number ________.
- Proof of current residence: a copy of my ________.
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§ 7. Personal Identification Number. I request that you provide me with a unique personal identification number or password to be used by me when authorizing the temporary lift or permanent removal of this freeze. Please send such number or password to me at the address set forth above.
§ 8. No Charge. I understand that, pursuant to 15 U.S.C. § 1681c-1(i), the placement, temporary lift, and removal of a security freeze must be provided to me free of charge.
§ 9. Contact. Please contact me at the address, telephone number, or email address set forth above if you require any additional information to process this request.
Thank you for your prompt attention to this matter. I look forward to receiving confirmation that a security freeze has been placed on my credit file, along with any personal identification number or password that I may need to lift or remove the freeze in the future.
Respectfully,
_____________________________
________
Signed on: ________
Enclosures: copy of proof of identity; copy of proof of residence.