Verification and Service Agreement Form
Please complete the following to verify your identity, provide address confirmation, and acknowledge service terms.
Client First and Last Name
Driver's License (Upload Image or PDF)
Upload a File
Drag and drop files here
Choose a file
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of
Utility Bill (Upload Image or PDF)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
I do not have a utility bill to upload
No Utility Bill
Alternative Address (if no utility bill is provided)
MyEquifax Username or Email
*
For accessibility purposes, your credit monitoring account email will be temporarily updated to allow uninterrupted access during the repair process. Once services are complete, we’ll restore your original email.
MyEquifax Password
*
Contact First and Last Name
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I acknowledge and accept the service terms
Service Acknowledgment
I have read and agree to the payment terms
Payment Terms
Digital Signature
Signee Full Name
First Name
Last Name
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