Equifax Security Freeze
P.O. Box 105788
Atlanta, GA 30348


Date: __________________________


Dear Equifax:


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

_______________________________________________


My current address is:

_______________________________________________

_______________________________________________


My date of birth is:

_____________________________


My social security number is:

_____________________________



Credit card information (if applicable).

Please charge the $________ fee to the following credit card:

name on card - _______________________________________________

type - ________________________________________ (Visa, MasterCard, Discover, AMEX)

number - ______________________________________

exp. date - ___________________________________

card ID# - ____________________________ (V/M/D back 3 digits; A front 4 digits)



Yours truly,


Enclosure:
copy of current utility bill