REQUEST TO OBTAIN MY FREE CREDIT REPORT

PLEASE PRINT
Name:
LAST NAME FIRST NAME INITIAL SUFFIX (Sr., Jr., etc.)

Current Address:
STREET ADDRESS APT. CITY PROVINCE POSTAL CODE

PREVIOUS ADDRESS(ES) (within last 3 years)

STREET ADDRESS APT. CITY PROVINCE POSTAL CODE

STREET ADDRESS APT. CITY PROVINCE POSTAL CODE

Date of Birth: Social Insurance Number:
MONTH/DAY/YEAR (OPTIONAL)

The name and last 4 digits of a major credit card:

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PLEASE SEND YOUR COMPLETED FORM WITH PHOTOCOPIES OF YOUR IDENTIFICATION TO:
Mail: National Consumer Relations
P. O. Box 190, Station Jean-Talon
Fax: 514-355-8502
Montreal, Quebec H1S 2Z2

SIGNATURE DATE
There is another credit reporting agency in Canada that provides this service.
Trans Union of Canada
P. O. Box 338 L.C.D.I. Hamilton, Ontario L8L 7W2
Telephone: 1-800-663-9980 Telephone: 1-877-713-3393 (for Quebec)
† YES, I WOULD ALSO LIKE TO PURCHASE MY EQUIFAX CREDIT SCORE FOR $9.95 (tax included)
I authorize Equifax to charge $9.95 to my credit card: † VISA † MasterCard † AMEX

Cardholder Name: __________________________________________________________

Card Number: ___________________________ Expiry Date: _____________________

MONTH/DAY/YEAR
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