Evergreen Credit Reporting, Inc. - www.creditreporting.com
(Please use black ink and print clearly!)

Yes, I want my Credit Report including information from All 3 National Credit Bureaus-
Equifax, Experian and TransUnion.   I authorize First American Credco, provider of credit reports for Evergreen Credit Reporting, Inc. to obtain my report from the 3 national credit bureaus.

Your Signature Required: ____________________________________________________________________

1. Select your Credit Report and Delivery Option (Choose Only One)

• Report delivered by US Postal Service First Class Mail

  __ $29.90     3 Bureau Credit Report
  __ $39.95     3 Bureau Credit Report with All 3 Credit Scores

• Report delivered by US Postal Service Priority Mail (usually 2-3 days, sometimes longer)

  __ $33.90     3 Bureau Credit Report
  __ $43.85     3 Bureau Credit Report with All 3 Credit Scores

• Report delivered by US Postal Service Express Mail Service (usually overnight, sometimes longer)
  • Your application must be here by noon Pacific Time
  • APO's, AK, HI or outside Continental US - use US Express Mail
  • Delivers on weekends
  • Does not require a delivery signature

__ $47.90     3 Bureau Credit Report
__ $57.85     3 Bureau Credit Report with All 3 Credit Scores

• Report delivered by Airborne Next Afternoon Service (usually overnight, sometimes longer)
  • Does not deliver to PO boxes or APO's
  • Does not deliver or pick up on weekends
  • Requires a signature upon delivery
  • No Airborne delivery for AK, HI or outside Continental US

__ $41.90     3 Bureau Credit Report
__ $51.85     3 Bureau Credit Report with All 3 Credit Scores

2. Complete your personal information

(Use the exact name you apply for credit under, i.e., your name on your credit card.)

Full Name: _________________________________________________________________

Date of Birth: ____ | _____ | _________ Social Security Number: ________ | ________ | ___________

Full Current Address: ________________________________________________________________________

Daytime Phone:(_______) ____________________ Evening Phone: (________) ________________________

Email Address: ___________________________________________________
___ Check here to get our newsletter emailed to you.

 

3. Select A Payment Option (choose one from our 3 payment options)

Electronic Check (only available for faxed orders). For us to electronically debit your checking account, Please:
      1.  Complete your check made payable to Evergreen Credit Reporting, Inc. for proper amount
      2. Sign the check and
      3. Fax a copy of the check with this application.
      We will debit your checking account electronically (using an ACH entry) prior to running your credit report.

4. Required with your application:

One of the following items showing your name and current address must be sent with your completed application.
Copies of original documents only -- no evelopes. For example, send or fax a copy of an official document from the following list below, showing your name and current address. such as your:

5. Mail or Fax to:

Evergreen Credit Reporting, Inc.
PO Box 96178
Las Vegas, NV 89193-6178
Phone: 1-888-762-4001           Fax: 1-800-797-9994

(Note: Fax orders must be paid by debit or credit card or electronic check. To confirm receipt of your fax, please call us.) There are no refunds once your credit report is ordered and processed.)

Resident of Illinois: Credit reporting agencies are required are required by Illinois law to give you a copy of your credit report upon request, at no charge, or for a nominal fee.