Premium Form | SafeRent Resident Screening Report – CoreLogic, Inc.

All information in this document is private and confidential.

Dear Disclosure Officer – I am writing to request that CoreLogic SafeRent please provide a consumer report disclosure to me by postal mail. Where available, the company’s response must include all information in the file, including sources and disclosures. My information is provided below; you may contact me directly to confirm my identity.

The Fair Credit Reporting Act (FCRA) stipulates that a nationwide specialty consumer reporting agency, “shall make all disclosures…once during any twelve month period upon request of the consumer and without charge to the consumer.” In addition, “nationwide specialty consumer reporting agencies may furnish a consumer report in accordance with the written instructions of the consumer to whom it relates.” (

In addition, all nationwide specialty consumer reporting agencies, “must provide a toll-free number that is published in every telephone directory in which a number for the company appears, and is clearly and prominently posted on the company’s website. In addition, federal law requires the company to have clear and easy instructions for consumers to get these reports, and adequate staff in place or means to deal with consumers’ requests.” (

Please Review and Complete the following information.

Section I – Primary Identification Information


*Most reporting agencies require Social Security number to verify consumer information. 


Section II – Supplemental Information – Other Names

Please list all other names that would have been given to any related company in the last seven years. This additional information may assist in the identification of records, should there be any records with similar identifiers. Please write NO or NA if this is not applicable.

Leave this empty:
Signature Certificate
Document name: Premium Form | SafeRent Resident Screening Report – CoreLogic, Inc.
Unique Document ID: 3353c27dd57279e035673d2de4f5eef0c10b0c73
Timestamp Audit
2016-04-05 03:38:16 EDTPremium Form | SafeRent Resident Screening Report – CoreLogic, Inc. Uploaded by Ben Gurion - IP