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    Personal - Lexis Nexis C.L.U.E. Auto Property Request Form

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    Empresario
    The document is a C.L.U.E. Auto/Property Request Form from LexisNexis Consumer Center that requests personal information such as name, address, driver's license details to provide consumer reports on auto and property records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Personal - Lexis Nexis C.L.U.E. Auto Property Request Form

    Uploaded by

    Empresario
    102 views2 pages
    The document is a C.L.U.E. Auto/Property Request Form from LexisNexis Consumer Center that requests personal information such as name, address, driver's license details to provide consumer reports on auto and property records.

    Original Description:

    Personal - Lexis Nexis C.L.U.E. Auto Property Request Form

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    © © All Rights Reserved

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    The document is a C.L.U.E. Auto/Property Request Form from LexisNexis Consumer Center that requests personal information such as name, address, driver's license details to provide consumer reports on auto and property records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    102 views2 pages

    Personal - Lexis Nexis C.L.U.E. Auto Property Request Form

    Uploaded by

    Empresario
    The document is a C.L.U.E. Auto/Property Request Form from LexisNexis Consumer Center that requests personal information such as name, address, driver's license details to provide consumer reports on auto and property records.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    LexisNexis® Consumer Center

    Attn: FACTA
    P. O. Box 105108
    Atlanta, GA 30348
    consumer.documents@LexisNexis.com

    C.L.U.E. Auto/Property Request Form

    □ □ □
    Order Options:

    □ C.L.U.E. Auto Report C.L.U.E. Property Report Both Reports

    Shaded information is required – please print clearly

    ______________________________________________________ ____________________________________
    First Name (required) Middle Name (required unless none)

    _________________________________________________________________________________________________
    Last Name (required) Suffix (Sr., Jr., III, etc.)

    __________ - ________ - ______________ _____________ - ______ - _____________ ____________


    Social Security Number (required) Date of Birth (Month-Day-Year – required) Gender (M/F)

    Current physical address


    _________________________________________________________________________________________________
    Current Street Address (required) Apt. #

    _________________________________________________________________________________________________
    City (required) State (required) ZIP (required)

    __________ - _________ - ________________


    Phone Number

    Complete this section if you have lived at your current address for less than six (6) months
    _________________________________________________________________________________________________
    Previous Street Address Apt. #

    _________________________________________________________________________________________________
    Previous City Previous State Previous ZIP

    Page 1 CD105m-01-16f
    LexisNexis® Consumer Center
    Attn: FACTA
    P. O. Box 105108
    Atlanta, GA 30348
    consumer.documents@LexisNexis.com

    C.L.U.E. Auto/Property Request Form

    Complete this section if your mailing address is different from your current address
    _________________________________________________________________________________________________
    Mailing Address Apt. #

    _________________________________________________________________________________________________
    City State ZIP

    Complete this section if you are requesting C.L.U.E. property reports on a residential property or vacation home
    _________________________________________________________________________________________________
    Street Address Apt. #

    _________________________________________________________________________________________________
    City State ZIP

    Complete this section if you are requesting a C.L.U.E. auto report

    ___________________________________________________ _______________________________________
    Driver’s License Number Driver’s License State

    ___________________________________________________ _______________________________________
    Previous Driver’s License Number Previous Driver’s License State

    _________________________________________________________________ ___________________________________
    Signature (required) Date (required)

    Page 2 CD105m-01-16f

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