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Disapproval Of Credit Other Than By Credit Bureau
(A demand for disclosure of credit information from an entity other than a credit bureau.)
On [Date], you notified me that my application for loan credit was denied for reasons based on information received by you from a person other than a consumer reporting agency.
Accordance with my rights under federal and other laws, I request that the nature of the information received by you be disclosed to me in a timely fashion.
Signature of Customer