PRINT & COMPLETE THIS FORM
MAIL TO:
AXIS INVESTIGATIONS
PO Box 941821, Simi Valley, CA 93094
Questions? Call: 1-818-312-3763
AUTHORIZATION TO RELEASE CREDIT INFORMATION
TO: Credit Reporting Agency and/or Creditor
RE: My Credit Report
I hereby authorize release to Axis Investigations and/or its assigns, credit information contained in your file(s) relating to me.
I understand the record(s) provided will be furnished in confidence and I agree to
hold the reporting agency and/or creditor harmless as a condition for providing the record(s).
A copy of this Authorization shall be valid as though it were the original and shall remain in effect for a period of thirty (30) days from the date entered below.
Date:_______________________
Signed:_______________________________________________________
Print Name:____________________________________________________
My Social Security Number is:______________________________________
I Reside At:____________________________________________________
street address
___________________________ __________________ _________
city state zip