Product: Credit reporting or other personal consumer reports

XXXX, XXXX XXXX , doing business as XXXX XXXX, being first duly sworn, deposes and states as follows : 1. **Affirmation of Denial of Credit and Non-Disclosure Violations** I hereby affirm that XXXX XXXX has unlawfully denied me credit based on information obtained from **Experian**, and Experian has failed to provide the necessary disclosures required under 15 USC 6802, causing me significant civil damages. I request that Experian provide evidence and a rebuttal of the following claims, as outlined below.

2. **Request for Proof of Claim - Disclosure Forms ( Form A, Form B, Form C ) ** I accept for value and return for value with a request for proof of claim that XXXX XXXX lawfully denied me credit based on information obtained from **Experian**, without Experian providing the required disclosure forms as mandated by 15 USC 6802. Specifically, I request evidence that XXXX XXXX provided the following : - Form A : Clear and conspicuous written notice that my personal information may be disclosed to third parties.

- Form B : The opportunity for me to opt out of information disclosure.

- Form C : Instructions for how to exercise my opt-out rights before my nonpublic personal information was shared with third parties.

3. **Request for Proof of Claim - Clear and Conspicuous Disclosure** I request proof from **Experian** and XXXX XXXX that XXXX XXXX provided clear and conspicuous written disclosure to me stating that my personal information may be shared with third parties as required under 15 USC 6802 ( b ) ( 1 ) ( A ). I request rebuttal if such disclosure was not provided.

4. **Request for Proof of Claim - Opportunity to Opt Out** I request evidence from **Experian** and XXXX XXXX confirming that XXXX XXXX provided me with the opportunity to opt out of the disclosure of my personal information before it was shared, as required under 15 USC 6802 ( b ) ( 1 ) ( B ). If this was not offered, I request a rebuttal.

5. **Request for Proof of Claim - Explanation of Opt-Out Rights** I request evidence from **Experian** and XXXX XXXX that XXXX XXXX provided clear instructions explaining how I could exercise my right to opt out of having my personal information disclosed to third parties, as required under 15 USC 6802 ( b ) ( 1 ) ( C ). If this was not provided, I request a rebuttal.

6. **Request for Proof of Claim - Lawful Authority to Deny Credit** I request proof that XXXX XXXX had lawful authority under UCC 3-303 to deny credit without first establishing the value of my application and without following the required disclosure procedures. If XXXX XXXX or Experian disputes this, I request a rebuttal.

7. **Request for Proof of Claim - Compliance with Disclosure Requirements for Denial of Credit** I request proof that the credit denial decision made on XXXX XXXX, XXXX, was in full compliance with all disclosure requirements under 15 USC 6802, including but not limited to the following reasons for denial : - Delinquency on one or more accounts.

- Length of time accounts have been established.

- High ratio of loan balances to loan amounts.

- Lack of recent credit card account information.

I request a rebuttal if any of these factors were used in violation of the disclosure requirements outlined in 15 USC 6802.