Experian Security Freeze
P.O. Box 9554
Allen, TX 75013

Date: __________________________

Dear Experian:

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

_______________________________________________

My date of birth is:

_____________________________

My social security number is:

_____________________________

My current address is:

_______________________________________________

_______________________________________________

Previous addresses and dates if at current address for less than two years.

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

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 – ___________________________________

Yours truly,

Enclosures:
copy of driver’s license, state or military ID
copy of current utility bill, bank statement or insurance statement