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MiddleLast
The following information is gathered to assist in verifying your dispute. Please ensure to supply the
required information and complete the authorization on the back of the form.
Consumer's Name
First Jr/Sr
Other:
Social Insurance Number (Optional)
Current Address
Number & Street
Apartment City Prov/Postal
Previous Address
Number & Street
Apartment City Prov/Postal
Date of Birth (mm/dd/yyyy)
Employment (optional)
Home Phone (optional)
If any of the personal information supplied
on this form is not listed in my credit file, I
request that it be incorporated into
TransUnion's file
Yes
No
Signature of Consumer (required) Date
IF YOU DISAGREE WITH ACCURACY OR COMPLETENESS OF YOUR INFORMATION, PLEASE NOTE BELOW. USE
ADDITIONAL PAPER IF NECESSARY, ENSURING THAT EACH ADDITIONAL PAGE CONTAINS YOUR SIGNATURE.
Company Name:
Company Name:
Account #: Account #:
No Knowledge of this Account
Included in Bankruptcy
Paid Before Collection/Write off
Account Not Reporting
Paid in Full
Included in Bankruptcy
Account Not Reporting
No Knowledge of this Account
Paid Before Collection/Write off
Paid in Full
Other:
Please Note: This form is only to be returned to TransUnion if you wish to dispute information on your
credit file.
TU Case ID
Contact Information
Telephone: 1-800-663-9980
www.transunion.ca
INVESTIGATION REQUEST FORM
Authentication Reference
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Would you like your investigation notification
Emailed
Mailed
or
Email Address
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CONSUMER RELATIONS CENTRE
3115 Harvester Road, Suite 201
Burlington, Ontario
L7N 3N8
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Company Name:
Account #:
No Knowledge of this Account
Company Name:
Account #:
No Knowledge of this Account
Account Not Reporting
Paid Before Collection/Write off
Included in Bankruptcy Included in Bankruptcy
Paid Before Collection/Write off
Account Not Reporting
Company Name:
Account #:
Other: Other:
Account #:
Company Name:
No Knowledge of this Account
No Knowledge of this Account
Included in Bankruptcy
Included in Bankruptcy
Paid Before Collection/Write off
Paid Before Collection/Write off
Account Not Reporting
Account Not Reporting
Other: Other:
ADDITIONAL COMMENTS
To investigate your dispute we will contact the source of the disputed information by phone and/or fax. Each source will
be advised as to the nature of your dispute and will be requested to verify the accuracy and/or the completeness of the
information they reported. If our investigation does not resolve your dispute you may add an explanation statement to
your report. All provinces allow a statement added of up to 100 words, except Saskatchewan - 200 words. If you would
like to add a statement, please print the statement on a separate sheet of paper and attach it to this form.
**RETURN THIS FORM TO THE ADDRESS LISTED AT THE TOP OF YOUR REPORT**
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I HAVE READ AND UNDERSTOOD THE ABOVE STATEMENTS AND HAVE PROVIDED INFORMATION THAT
IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND ACCURATE. I AUTHORIZE YOU TO FOLLOW THE
PROCEDURES OUTLINED ABOVE IN AN ATTEMPT TO VERIFY THE INFORMATION THAT I AM DISPUTING.
Paid in Full
Paid in Full
Paid in Full
Paid in Full
DateSignature
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