Product: Credit reporting, credit repair services, or other personal consumer reports

ATTN : REGISTERED AGENT FOR XXXX XXXX XXXX Pursuant to 15 USC 1692c. ( c ) I am notifying you in writing that I refuse to pay this alleged debt, and I am demanding that you cease all forms of communication with me through any and all mediums unless it pertains to my remedy in writing via mail. 
Pursuant to 15 USC 1692c. ( c ) ( 2 ) - I am invoking my specified remedy as a consumer, and the original creditor I am demanding all of the following : Clear out payment history Change all payment history to paid as agreed or on-time.

Zero out on my open ended consumer plan balance monthly Do not close my account ( s ) without authorized permission. 
Do not seize or attempt to seize anything in my possession. 
Remove all remarks or comments off my consumer report. 
Return requested documents so I can properly assess the validity of any debt Cease and rescind use of my intellectual property, my signature. 



1. Name and address of the original creditor who created the debt. 
2. Name on file of alleged debtor. 
3. Alleged account # 4. Address on file for alleged debtor. 
5. Amount of alleged debt. 
6. Date this alleged debt became payable. 7. Date of original charge or delinquency. 
8. Was this debt assigned to a debt collector or purchased?

9. Amount paid if debt was purchased.

10. Commission for debt if collection efforts are successful.

11. Documentary evidence that this agency is in fact the holder in due course.

12. Certified copy of the original negative information notice required by FCRA section 623 ( 7 ) ( A ). 
Please provide the name and address of the bonding agent for ( Name of Debt Collector ), in case legal action becomes necessary : Authorized Signature of Creditor : Date : You must return this completed form along with copies of ALL requested information, assignments or other transfer agreements, which would establish your right to collect this alleged debt within thirty days from the date of your receipt of this letter. Please be aware I understand falsifying and concealing documentary evidence of statements of entries is punishable under Title 18 U.S.Code 1001 for up to five years of imprisonment. 
Without the information which is required by law for your offices to have on file there is no valid way that your office can validate any alleged debt. 
Your claim can not and WILL NOT be considered if any portion of this form is not completed and returned with copies of all requested documents. This is a request for validation made pursuant to the Fair Debt Collection Practices Act. 
To acquiesce or failure to comply with the requirements of this notice would be admittance to stating there is no proof of claim for this alleged debt, you agreed to discharge the matter accordingly not sell or assign this matter to another agency, as well as remove the false allegation off of all of my consumer reports and will compensate me accordingly in the amount of the presented invoice in good faith and ordinary care for the financial damage caused by the reporting false false allegation. 
Your prompt attention and response is both requested and required. 
Signature