MANUAL CREDIT DISPUTE FORM

Name

Phone

Date of Birth

Social security number

Email

Experian Username

Experian Password

Experian Security Answer

Experian 4 Digit Pin

My Free Score Now username

My Free Score now Password

Address

City

State

Zip

Upload Drivers license

Upload SSC

Upload Utility Bill, Cable Bill, Phone Bill, Internet Bill, or Passport ONLY

* Must Show Current Address as this will be Proof Of Address

Upload Utility Bill, Cable Bill, Phone Bill, Internet Bill, or Passport ONLY * Must Show Current Address as this will be Proof Of Address

CHECK YOUR EMAIL FOR FURTHER INSTRUCTIONS

Email Will be sent in 1 to 3 days

I know credit repair won’t start until all documents are

submitted.

I know credit monitoring (MFSN) must stay active for 4 straight months.

I understand services will end if My Free Score Now is not active.

I agree to keep monitoring active. I know no reminders will be sent.