Card Authorization For

$1 Credit Authorization Form

Thank you for choosing The Credit Institute to assist you with your credit restoration needs. We would need the following personal and billing information in order to pull your credit reports. Once the reports are pulled we will call you to discuss your reports in details.

Please note by submitting the information below you authorize The Credit Institute to charge the credit card in the amount of $1. ($1 charge will be listed on your bank statement as "IdentityIQ" for the service of obtaining credit reports)

Again, thanks for choosing The Credit Institute to assist you with your credit restoration needs. If you have any questions feel free to contact us at 855-319-9270

Today's Date*

Date

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

E-mail*

Mobile Number*

Area CodePhone Number

Date of Birth*

Date

SS Number*

xxx-xx-xxxx

CC Type*

Billing address same as address above

Yes

Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Credit Institute Rep*

How did you hear about us?*

Name of the person or place that referred you?

Check for Accuracy

Please fill the above personal information and card authorzation sections with accuracy. You give us permission to charge your card for $1 for credit reports. Once you press submit this form will be forwarded to us and we will then contact you.

Thanks in advance for your business and please feel free to call us at 855-319-9270 with an immediate question or concern.

Credit Reports and Credit Monitoring Terms

You will be billed $1.00 now and then $21.99 monthly for as long as you continue your membership with IdentityIQ , after your 7 day trial. If you are not satisfied, you can cancel at any time to discontinue your membership and there will be no additional charges. By clicking on the “Submit” button below, you agree to the offer details, to the Terms and Conditions, acknowledge receipt of our Privacy Policy and agree to its terms, and confirm your authorization for IdentityIQ to obtain your credit profile from any consumer reporting agency for your own use, to confirm your identity to avoid fraudulent transactions in your name, and to monitor your credit for changes. To cancel services before 7 day trial is up call 877-875-4347.

Do you accept the above terms?*

Yes, I accept above terms

Sign*

Verification*