Identity Theft Affidavit Form - Wichita Police Department Page 9
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14SAMPLE DISPUTE LETTER to CREDIT REPORTING BUREAU
Date
Name of Company
Address
City, State, Zip Code
Re:
Your name
Your Address, City, State, Zip Code
Complaint Department
Dear Sir or Madam:
I am writing to dispute the following information in my file. I have circled the items in
dispute on the attached copy of the report I received.
This item(s) (identify items disputed by name of source: creditors or tax court. Also
identify type of item: credit account, judgment, etc.) is
inaccurate or incomplete
because
(describe what is inaccurate or incomplete and why). I am requesting that the item be
removed (or request another specific change) to correct the information.
Enclosed are copies of (use this sentence if applicable and describe any enclosed
documentation, such as a police report, ID Theft Affidavit, payment records or court
documents) supporting my position. Please reinvestigate
this or these
matter(s) and
delete or correct
the disputed item(s) as soon as possible.
Pursuant to FACTA, as a victim of identity theft I am also requesting that you provide
me with copies of any and all applications and business transaction records related to
the fraudulent account(s). The copies of the records can be mailed to me at the address
listed above. In addition, please make these records available to the Wichita Police
Department, Wichita, KS 67202, upon their request.
Sincerely,
Your name
Enclosed: (List everything you are enclosing)
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