(Send by certified mail)
Your full name
Current mailing address
Experian credit report file # ___________

Date

Experian
P.O. Box 9532
Allen, TX 75013

Dear Sir or Madam:
Please add the following statement to my credit file in reference to [account number and name of creditor]: 

On [date], I ordered a product from [creditor] that was of inferior quality and that was not as represented in the company’s advertising. On [date], I asked in writing for a full refund, but the company did not respond. While waiting to resolve the issue, I declined to pay my bill with the company. They, in turn, reported that payment was 60 days late. I have disputed this matter with both the company and the credit reporting agency, but it has not been resolved to my satisfaction.

I have included the following information as confirmation of my identity.

	• Phone number: ___________________________________________
	• Previous addresses from last two years: _________________
	• Social Security number: _________________________________
	• Date of birth: __________________________________________

I have also enclosed a copy of my [type of government-issued ID card, such as a driver's license or passport] and a [utility bill or bank statement] to authenticate my identity.

Thank you for your prompt attention to this matter.

Sincerely,
[Signature]
Your full name