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NAME County State

Petitioners Private International Administrative Remedy Demand # ___________

TO:

*credit reporting agency* *credit reporting agency address* (hereinafter referred to as Respondent) *Debtor Name* *Debtor SSN* *Debtor Address* (hereinafter referred to as Petitioner) Investigation and Correction of Credit History Information

RE:

SUBJECT:

BE IT KNOWN BY THESE PRESENTS, that: The Petitioner herein is *Name*, a major domiciliary and resident of *City, State*, who shows as follows: I have previously notified you of the incorrect information contained in my credit history report maintained by your organization. I have requested, in writing, that the information be removed from my file for inaccuracies and/or unverified entries. I have requested, in writing, that you provide me with written documentation regarding the methods you would employ to investigate the disputed entries in my credit file. You have failed to provide me with any documentation to indicate that you have investigated my request as per The Fair Credit Reporting Act Furthermore, although I am in receipt of your presentments in this matter, copies of which are attached hereto as exhibits, you have failed to provide me with any documentation regarding the method you would employ to investigate the disputed entries in my credit files. 15 U.S.C. 1681, et seq. provides as follows: Description of reinvestigation procedure. A consumer reporting agency shall provide to a consumer a description referred to in paragraph (6)(B)

(iii) by not later than 15 days after receiving a request from the consumer for that description. In general. If, after any reinvestigation under paragraph (1) of any information disputed by a consumer, an item of the information is found to be inaccurate or incomplete or cannot be verified, the consumer reporting agency shall promptly delete that item of information from the consumers file or modify that item of information, as appropriate, based on the results of the reinvestigation. (emphasis added) Blacks Law Dictionary defines Verification as follows: Confirmation of correctness, truth, or authenticity, by affidavit, oath, or deposition. Affidavit of truth of matter stated and object of verification is to assure good faith in averments or statements of party. . . (emphasis added) You are hereby notified that you are in willful violation of the law as set forth in 15 U.S.C. 1681, et seq. and that you could be held liable for tort damages payable to the Petitioner herein due to your willful disregard for these provisions n the law. Verification as it relates to this matter, will be deemed accomplished only if provided in accordance with law as outlined above. This document is to notify you that you have ten (10) calendar days from your receipt hereof, exclusive of the date of service, to comply with the demands of my previous correspondence. All future correspondence regarding this matter, including your response hereto, shall be directed to me in care of _______________________, Notary Public, who will record all documentation regarding this matter under administrative procedure number ____________________________. Furthermore, you are hereby requested to immediately forward to me the name and address of your bond issuing agent and/or company, and your bond number relating to your business actions, together with the name, address and policy numbers relating to any insurance coverage maintained by your company relative to your actions herein. By: _______________________________ NAME ADDRESS

AFFIDAVIT STATE OF __________________ COUNTY OF ________________ BEFORE ME, the undersigned authority, personally came and appeared _______________________________, who after being duly sworn, did depose and state that affiant is the Notary Public and process server and keeper of the records in connection with Administrative Remedy Demand Number

________________, in which *Debtor* is the petitioner in an action to have *Credit Reporting Agency* perform its duties as required under the provisions of the Fair Credit Reporting Act, i.e. 15 U.S.C. 1681, et seq. and that *Credit Reporting Agency* has received correspondence dated __________________, a copy of which has been filed into the record of this Administrative Remedy Demand Number _________________ as is evidenced by its signatures on the return receipts for each said item of correspondence. Further, affiant states that *Credit Reporting Agency* has failed to respond to said correspondence as set forth in the record of the Administrative Remedy Demand, Number _________________. ________________________ NOTARY/RECORDKEEPER SWORN TO and SUBSCRIBED before me, Notary, this ____ day of ___________, 2004, at _____________, ________________ County, _________________. _______________________________ NOTARY PUBLIC My Commission Expires:________________________

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