Credit Health (Pty) Ltd 14th Floor, Rennie House 19 Ameshof Street Braamfontein Tel: 011 242-4901

Fax Nr / Faks: 0865844236 CONFIDENTIAL - PERMISSION TO OBTAIN CREDIT INFORMATION I, Jolene Washer (8309130320085), authorise Credit Health to obtain my credit information from the XDS credit bureau and to: • Compile this into a Free Credit Report and provide it to me as a PDF document by email • Store my credit information on Credit Health’s confidential database for a period of 30 days from the date on which Credit Health receives it, and then to delete it • Only if I request Credit Health to, obtain any and all balance and statement information from any of my creditors, and • Only if applicable, provide my information to Logan Attorneys so that they can provide me with information on the clearing of my credit record of negative information • Obtain my credit information from TransUnion and Experian in the event that I choose to purchase the Credit Health Report

Name and Surname:

Your Free Credit Report™ costs only

R0
Cell number:
Wow! Can that be right, a Free Credit Report? That's right, we'd like to provide you with a FREE report, which we know will be very useful to you.

Email address:

Signature:

Date:

Next steps:
1. Please email or fax us your Proof of ID and this signed Permission Form to iris@credithealth.co.za or fax
number 0865844236

2. Once received, you will have your Free Credit Report within 1 business day.

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