CREDIT INFORMATION BUREAU (INDIA) LIMITED

Credit Information Report Request Form

You can now access a copy of your Credit Information Report (CIR) from Credit Information Bureau (India)
Limited (CIBIL). The undermentioned information will be required to process your request. Any omission of
information will delay your request for want of clarifications. Hence, once information is duly filled please enclose
the completed form, necessary supporting documents & a demand draft for fees in an envelope, affix required
postage and mail to:

Credit Information Bureau (India) Limited, P.O. Box 17, Millennium Business Park, Navi Mumbai- 400 710

Once CIBIL receives the duly completed form, self attested identity proof and address proof copies and the fees,
your request will be processed and a copy of your CIR will be dispatched to you. If additional information is
required to process your request CIBIL will contact you by mail or email.
Your CIBIL CIR will be presented to you in a simple and easy to understand format. However, on receiving your
CIR, if you require any explanation/clarification, you can email us at consumerqueries@cibil.com or call us on 022-
61404300.

Name*

Address*
(Same as on the Address proof copy that you are submitting)

Town/City/District

State PIN Code*

Other Information
Date of Birth* (dd/mm/yyyy) Mobile Number

Telephone Number(s)
STD Code Phone Number

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Email

Identity proof *
(Self attested copy of any one of the below mentioned Identity proof is mandatory. Please tick on the option that
you are submitting as identity proof and mention the identification number)

PAN Card (Recommended) Passport Voters ID

PAN Number Passport Number Voters ID Number

Address proof *
(Self attested copy of any one of the below mentioned Address proof (not older than 3 months from the date of
application) is mandatory. Please tick on the option that you are submitting as Address proof)

Bank Statement Electricity Bill Telephone Bill

Payment*
Please send a Demand Draft of Rs 142/- (inclusive of taxes and express delivery charge), in
favour of “Credit Information Bureau (India) Limited”, payable at Mumbai.
Please note that this fee once paid is non-refundable.

Demand Draft Number Date (dd/mm/yyyy)

Bank Name

_____________________________________________________________________________

I understand that the report is being provided to me upon my request and I hereby certify that the above information
related to me is true to the best of my knowledge and I undertake to use the report, once received, with adequate care
& for my own use.
Signature*
Date
___________________
*
Fields marked in asterix are mandatory
Regd Office: Hoechst House, 6th Floor, 193, Backbay Reclamation, Nariman Point, Mumbai 400 021, India

Please note:
CIBIL has no authorised agents. Please do not contact anyone other than CIBIL in order to gain access to a copy of your Credit Report.

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© COPYRIGHT 2009 CREDIT INFORMATION BUREAU (INDIA) LIMITED. ALL RIGHTS RESERVED