CERTIFIED MAIL# 1234 1234 1234 1234 1234 RRR
Block Information on Your Existing Account
Date:
To: (Credit Reporting Agency)
Re: (Name, SSN, DOB)
Address: 1234 Main Street
Anywhere, USA 12345
To whom it may concern:
I am writing to dispute fraudulent charges on my account. The charge made on ___/___/___ and
in the amount of $ ________. I am a victim of identity theft, and I did not make or authorize
this charge. Please remove the fraudulent charges and any finance charge or other charges related
to the fraudulent charges. Please send me a corrected statement as soon as possible as per FRCA
laws. Please stop reporting information about the fraudulent charges to all credit reporting
companies.
I have enclosed proof of my identity, a copy of my Identity Theft Report, and a copy of my
credit report that shows the fraudulent items related to my account with your company. I have
also enclosed a copy of the Notice to Furnishers of Information issued by the Federal Trade
Commission. The notice explains your responsibilities under the Fair Credit Reporting Act. The
Notice also explains that when a credit reporting company notifies you that information you sent
it may be a result of identity theft, you must stop sending that information to any credit reporting
company, and be sure you don't try to sell or transfer the fraudulent debts to another party for
collection.
Please investigate the fraudulent charges and send me a letter explaining your action.
Sincerely,
Enclosures:
Identity Theft Report, Proof of Identity, Copy of account statement showing fraudulent items,
FTC Notice to Furnishers of Information, My Credit report with information to be corrected
(sanitize your report by blacking out information that is not directly related to this company),
FTC Notice to Furnishers of Information (http://www.consumer.ftc.gov/articles/pdf- 0092notice-to-furnishers.pdf)
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