Sample letter form

Date:

Address of credit reporting agency

I would like to place a security freeze on my credit file.  My complete name is ______________.

My current address is ______________.        

If I have lived at the above address less than one year, my former address was ______________.

My social security number is __________.

Circle one:  I am an identity theft victim and I enclose a copy of my federal trade commission victim’s affidavit or police report.

Or:  I am a concerned consumer.  [Note:  There is no fee for a first freeze request.  If this if your second or subsequent request, a fee of $5 is required].

(If fee is required)  Attached is my payment for the freeze.

Credit card number:                                          Expiration date:

Money order number:                                       Check number:

Attached is the required documentation (i.e., proof of being an identity theft victim).

Very truly yours,