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Exact Background Checks ConsumerDisputeForm|Page1of5
ConsumerDisputeForm
InstructionsIfyoubelievethereisinaccurateorincompleteinformationinyourreport,youhavetherighttofileaconsumerdisputewithExact Background Checks.Wewillreinvestigatethereportfreeofchargeandmakeanynecessarychangeswithin30daysofreceivingthisform.
Step1:Completethisform.IntheNatureofDisputesection,trytobeaspreciseaspossibleaboutwhyyoubelievethedisputedelement(orelements)isinaccurateorincomplete.
Step2:Attachanysupportingdocumentation(optional).Ifyouhavesupportingdocumentation(e.g.,acourtexpungementletter,proofofemployment,etc.)besuretoincludeacopywithyourform.Yourdetailedexplanationand/orsupportingdocumentationcouldhelptoexpeditethereinvestigationprocessandresolveyourdisputequicker.
Step3:Submitthisformandanysupportingdocumentation.Email,faxormailinyourcompletedformandsupportingdocumentationtoourSupportteam.Forsecuritypurposes,pleasesendanysupportingdocumentationviamail.
MailingAddress:Exact Background Checks4261 E. University Dr., Suite 30-352Prosper, TX 75078
Phone:844-97CHECK(Mon-Fri:8am-8pmEST)
YourFullLegalName
YourPhysicalAddressasitappearsontheconsumerreport
Address
City State ZipCode
Youremailaddress DateoftheReport
TheNameoftheEmployerthatRantheReport
Exact Background Checks ConsumerDisputeForm|Page2of5
DisputedReportElements
NatureofDispute
When,followingtheappropriateresearch,thedisputehasbeencompletedandinfohaseitherbeenremoved,modifiedornotchanged,doyouconsenttoreceivingthatcorrespondenceelectronically.Ifyoudonotprovideauthorization,wewillsendyournoticebyregularmail.Thiscanresultindelayedcommunication.
Iconsenttoreceivecorrespondenceelectronically.
Exact Background ChecksConsumerDisputeForm|Page3of5
SectionIV:ASummaryofRightsUnderTheFCRA
Parainformaciónenespañol,visitewww.consumerfinance.gov/learnmoreoescribeala ConsumerFinancialProtectionBureau,1700GStreetN.W.,Washington,DC20552.
ThefederalFairCreditReportingAct(FCRA)promotestheaccuracy,fairness,and privacyofinformationinthefilesofconsumerreportingagencies.Therearemanytypesof consumerreportingagencies,includingcreditbureausandspecialtyagencies(suchasagencies thatsellinformationaboutcheckwritinghistories,medicalrecords,andrentalhistoryrecords). HereisasummaryofyourmajorrightsundertheFCRA.Formoreinformation,including informationaboutadditionalrights,gotowww.consumerfinance.gov/learnmoreorwrite to:ConsumerFinancialProtectionBureau,1700GStreetN.W.,Washington,DC20552.
• Youmustbetoldifinformationinyourfilehasbeenusedagainstyou.Anyonewhouses acreditreportoranothertypeofconsumerreporttodenyyourapplicationforcredit, insurance,oremployment–ortotakeanotheradverseactionagainstyou–musttellyou,and mustgiveyouthename,address,andphonenumberoftheagencythatprovidedthe information.
• Youhavetherighttoknowwhatisinyourfile.Youmayrequestandobtainallthe informationaboutyouinthefilesofaconsumerreportingagency(your“filedisclosure”). Youwillberequiredtoprovideproperidentification,whichmayincludeyourSocial Securitynumber.Inmanycases,thedisclosurewillbefree.Youareentitledtoafreefile disclosureif:
• apersonhastakenadverseactionagainstyoubecauseofinformationinyourcredit report;• youarethevictimofidentitytheftandplaceafraudalertinyourfile;• yourfilecontainsinaccurateinformationasaresultoffraud;• youareonpublicassistance;• youareunemployedbutexpecttoapplyforemploymentwithin60days.
Inaddition,allconsumersareentitledtoonefreedisclosureevery12monthsuponrequest fromeachnationwidecreditbureauandfromnationwidespecialtyconsumerreporting agencies.Seewww.consumerfinance.gov/learnmoreforadditionalinformation.
• Youhavetherighttoaskforacreditscore.Creditscoresarenumericalsummariesof yourcredit-worthinessbasedoninformationfromcreditbureaus.Youmayrequestacredit scorefromconsumerreportingagenciesthatcreatescoresordistributescoresusedin residentialrealpropertyloans,butyouwillhavetopayforit.Insomemortgagetransactions, youwillreceivecreditscoreinformationforfreefromthemortgagelender.
• Youhavetherighttodisputeincompleteorinaccurateinformation.Ifyouidentify informationinyourfilethatisincompleteorinaccurate,andreportittotheconsumer reportingagency,theagencymustinvestigateunlessyourdisputeisfrivolous.Seewww.consumerfinance.gov/learnmoreforanexplanationofdisputeprocedures.
Exact Background Checks ConsumerDisputeForm|Page4of5
• Consumerreportingagenciesmustcorrectordeleteinaccurate,incomplete,or unverifiableinformation.Inaccurate,incomplete,orunverifiableinformationmustbe removedorcorrected,usuallywithin30days.However,aconsumerreportingagencymay continuetoreportinformationithasverifiedasaccurate.
• Consumerreportingagenciesmaynotreportoutdatednegativeinformation.Inmostcases,aconsumerreportingagencymaynotreportnegativeinformationthatismorethansevenyearsold,orbankruptciesthataremorethan10yearsold.
• Accesstoyourfileislimited.Aconsumerreportingagencymayprovideinformationabout youonlytopeoplewithavalidneed--usuallytoconsideranapplicationwithacreditor, insurer,employer,landlord,orotherbusiness.TheFCRAspecifiesthosewithavalidneed foraccess.
• Youmustgiveyourconsentforreportstobeprovidedtoemployers.Aconsumer reportingagencymaynotgiveoutinformationaboutyoutoyouremployer,orapotential employer,withoutyourwrittenconsentgiventotheemployer.Writtenconsentgenerallyis notrequiredinthetruckingindustry.Formoreinformation,gotowww.consumerfinance.gov/learnmore.
• Youmanylimit“prescreened”offersofcreditandinsuranceyougetbasedon informationinyourcreditreport.Unsolicited“prescreened”offersforcreditand insurancemustincludeatoll-freephonenumberyoucancallifyouchoosetoremoveyour nameandaddressfromtheliststheseoffersarebasedon.Youmayoptoutwiththe nationwidecreditbureausat1-888-5-OPTOUT(1-888-567-8688).
• Youmayseekdamagesfromviolators.Ifaconsumerreportingagency,or,insomecases, auserofconsumerreportsorafurnisherofinformationtoaconsumerreportingagency violatestheFCRA,youmaybeabletosueinstateorfederalcourt.
• Identitytheftvictimsandactivedutymilitarypersonnelhaveadditionalrights.For moreinformation,visitwww.consumerfinance.gov/learnmore.
StatesmayenforcetheFCRA,andmanystateshavetheirownconsumerreportinglaws.In somecases,youmayhavemorerightsunderstatelaw.Formoreinformation,contactyour stateorlocalconsumerprotectionagencyoryourstateAttorneyGeneral.Forinformation aboutyourfederalrights,contact:
ConsumerDisputeForm
Exact Background ChecksConsumerDisputeForm|Page5of5
TYPEOFBUSINESS: PLEASECONTACT:
1.a.Banks,savingsassociations,andcredit unionswithtotalassetsofover$10billionand theiraffiliates
b. Suchaffiliatesthatarenotbanks,savings associations,orcreditunionsalsoshouldlist,inadditiontotheCFPB:
ConsumerFinancialProtectionBureau 1700GStreet,N.W.Washington,DC20552
FederalTradeCommission:Consumer ResponseCenter–FCRAWashington,DC20580(877)382-4357
2.Totheextentnotincludedinitem1above:
a.Nationalbanks,federalsavingsassociations, andfederalbranchesandfederalagenciesof foreignbanks
b.Statememberbanks,branchesandagencies offoreignbanks(otherthanfederalbranches, federalagencies,andInsuredStateBranchesof ForeignBanks),commerciallendingcompaniesownedorcontrolledbyforeign banks,andorganizationsoperatingunder section25or25AoftheFederalReserveAct
c.NonmemberInsuredBanks,InsuredState BranchesofForeignBanks,andinsuredstate savingsassociations
d.FederalCreditUnions
a.OfficeoftheComptrolleroftheCurrency CustomerAssistanceGroup1301McKinneyStreet,Suite3450Houston,TX77010-9050
b.FederalReserveConsumerHelpCenterP.O.Box.1200Minneapolis,MN55480
c.FDICConsumerResponseCenter 1100WalnutStreet,Box#11KansasCity,MO64106
d.NationalCreditUnionAdministration OfficeofConsumerProtection(OCP) DivisionofConsumerComplianceandOutreach(DCCO)1775DukeStreetAlexandria,VA22314
3. Aircarriers Asst.GeneralCounselforAviation Enforcement&ProceedingsAviationConsumerProtectionDivision DepartmentofTransportation1200NewJerseyAvenue,S.E.Washington,DC20590
4. CreditorsSubjecttotheSurface TransportationBoard OfficeofProceedings,SurfaceTransportation BoardDepartmentofTransportation 395EStreet,S.W.Washington,DC20423
5. CreditorsSubjecttothePackersand StockyardsAct,1921 NearestPackersandStockyards Administrationareasupervisor
6. SmallBusinessInvestmentCompanies AssociateDeputyAdministratorforCapital AccessUnitedStatesSmallBusinessAdministration 409ThirdStreet,
S.W.,8th FloorWashington,DC20416
7. BrokersandDealers SecuritiesandExchangeCommission 100FStreet,N.E.Washington,DC20549
8. FederalLandBanks,FederalLandBank Associations,FederalIntermediateCredit Banks,andProductionCreditAssociations
FarmCreditAdministration 1501FarmCreditDriveMcLean,VA22102-5090
9. Retailers,FinanceCompanies,andAllOther CreditorsNotListedAbove
FTCRegionalOfficeforregioninwhichthe creditoroperatesorFederalTrade Commission:ConsumerResponseCenter– FCRAWashington,DC20580(877)382-4357