Consumer Document Request Form
This form is to be used to request a copy of your Consumer Background Investigative Report. Pursuant to
FCRA § 609 and the abridged notification in the included Summary of Your Rights Under the Fair Credit
Reporting Act, “Every consumer reporting agency shall, upon request, and subject to 610(a)(1) [§ 1681h],
clearly and accurately disclose to the consumer all information in the consumer's file at the time of the
request.”
To receive a copy of your Consumer Background Investigative Report by mail, simply COMPLETE and send the
form with the below identifying information along with proof of your identity. Proof of your identity can
include a photocopy of one of the following documents: a State Driver License, a State Issued ID Card, a
Military ID Card or a W2 form.
Required Information:
Social Security Number: ____ ____ ____ - ____ ____ - ____ ____ ____ ____
Name: ____________________________________________________________________________________
First
Last
Suffix
Street Address (residence):____________________________________________________________________
City, State, Zip: _____________________________________________________________________________
Phone Number: (_______)____________________________________________________________________
E-mail Address: _____________________________________________________________________________
Please read and sign the following statement. Your signature acknowledges your agreement.
By submitting this form, I state that all the information contained is true to the best of my knowledge.
Signature: _________________________________________________________Date: __________________
After completing this form, please return it by mail or fax. The mailing address and fax number are provided
below. Remember to include your proof of identity.
INTELIFI
Attn: Compliance Department
8730 Wilshire Blvd, Suite 412
Beverly Hills, CA 90211
Fax No. (310) 623-1820
Customer Service No (888) 409-1819
Thank you,
INTELIFI Compliance Department