Sample Consumer Report

JOHN C CONSUMER

123 MAIN ST

ANY TOWN MN 12345

ChexSystems will reinvestigate any item listed in your consumer report that you believe may be inaccurate or incomplete. In order for a reinvestigation to be initiated, please complete the enclosed form and mail it to the address listed above in our letterhead or by fax to 602-659-2197.

This report was prepared for JOHN C CONSUMER

Consumer ID:12345678 for JOHN C CONSUMER

Please provide your Consumer ID number, along with your Social Security number in any future contact with ChexSystems.

Inquiries Initiated By Consumer Action

Inquiries Initiated By Consumer Action refers to inquiries resulting from a transaction initiated by you. These include applying for a credit card or completing an application at a financial institution. Please note that the inquiries are part of your credit history and may be included in our reports to others. These inquiries can be viewed for ninety days up to three years.

Inquirer Name:

Any Town Savings

Inquirer Location:

Any Town MN

Inquiry Date:

02/28/2003

Name Provided:

John C Consumer

SSN/ID Provided:

999-99-9999

Inquiries Not Initiated By Consumer Action

Inquiries Not Initiated By Consumer Action refers to inquiries resulting from transactions you may not have initiated, so you may not recognize the source. Members of our service with a permissible purpose include current creditors, pre-approval creditors, and potential investors trying to assess risks. We report these requests only to you as a record of activities, and we do not include any of these requests on credit reports to others.

Inquirer Name:

Renaissance

Inquirer Location:

Beaverton CO

Inquiry Date:

03/24/2003

Name Provided:

John C Consumer

SSN/ID Provided:

999-99-9999

Retail Information

Retail Information refers to returned checks written on an account and certain collection accounts. Retailers and other businesses report this information to Shared Check Authorization Network (SCAN). ChexSystems receives this information directly from SCAN and is not involved in the collection of these items.

For additional information you may contact SCAN by telephone at 800-262-7771 or in writing to SCAN, Attention Research & Resolution, 7805 Hudson Road, Suite 100, Woodbury, MN 55125.

Date Of Check:

01/10/2002

Check Number:

6011

Amount Of Check:

$106.50

Date Check Paid:

Not Paid Yet

RTN/Account #:

12345678/98765543454

Drivers License:

X123456789123

State:

MN

Payee:

ABC Merchant

Date Of Check:

02/11/2003

Check Number:

7025

Amount Of Check:

$513.00

Date Check Paid:

08/23/2003

RTN/Account #:

12345678/98765543454

Drivers License:

X123456789123

State:

MN

Payee:

XYZ Stores

History Of Checks Ordered

History of Checks Ordered refers to a record of check orders placed within the past three years.

RTN/Account Number:

12345678 / 98765543454

Quantity Ordered:

400

Check Start Number:

6060

Date Order Shipped:

03/03/2002

Social Security Number Validation

Social Security Number Validation indicates the year and state that a particular sequence of digits first became available for issuance. This information does not include the name of the individual to whom the number was issued.

Drivers License Validation

Drivers License Number Validation indicates whether or not the format of the drivers license number provided matches the requirements set by the state of issuance.

Drivers License Verification

Drivers License Number Verification is information provided to ChexSystems by the state that issued the drivers license number. This information, which is limited to certain states, identifies the name and date of birth of the individual to whom the drivers license was issued.

Drivers License: X123456789123

State: MN

Issued To: John C Consumer

Date of Birth: 01/31/1978

ChexSystems Contact Information