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The document requires essential personal identification details, including full names, social security numbers, dates of birth, and residential history for both the applicant and their spouse, if applicable. It serves as a formal legal acknowledgment regarding the lawful use of credit data, providing critical information about the associated fees, which are twelve dollars per report. Furthermore, the form facilitates secure payment processing via credit card or check, ensuring that clients can obtain their financial reports for educational purposes while complying with federal requirements and credit inquiry protocols. By signing this document, users confirm their identity and authorize the necessary financial disclosure, ensuring a transparent and secure request process for managing personal credit records.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/credit-report-authorization-form-balance-financial-fitness-program/288946/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/credit-report-authorization-form-balance-financial-fitness-program/288946.png","ImageObject",442,249,{"name":88,"@type":89},"Margaret","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-07","2026-09-17",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",7,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the fee for accessing a credit report?","Question",{"text":109,"@type":110},"There is a fee of $12 for each individual credit report accessed through the BALANCE program.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"What are the payment options provided on the form?",{"text":114,"@type":110},"Clients can pay via credit card (Visa, MasterCard, or American Express) or by submitting a check or money order made out to BALANCE.",{"name":116,"@type":107,"acceptedAnswer":117},"Does requesting this report impact my credit file?",{"text":118,"@type":110},"Yes, the generation of this report is for educational purposes and will result in an inquiry appearing on your credit file.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},288946,1791153031,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":4},137451207643,"https://ap-avatar.wpscdn.com/davatar_3d24733baf745e90a7e4bdd5f77d97b2","CU 12  \nCredit Report Authorization Form  \n\n| Your Information |  |\n| --- | --- |\n| CREDIT UNION NAME |  |\n| COMPLETE NAME (first / middle initial / last / jr / sr) | SPOUSE’S NAME (only if you are requesting a report for your spouse) |\n| SOCIAL SECURITY NUMBER | SPOUSE’S SOCIAL SECURITY NUMBER |\n| DATE OF BIRTH | SPOUSE’S DATE OF BIRTH |\n| CURRENT ADDRESS (please include City, State and ZIP) |  |\n| PREVIOUS ADDRESS (within the last 5 years) |  |\n\n\n| Authorizing Signature(s) |  |\n| --- | --- |\n| By signing this form, I acknowledge that I am the person named above and I understand that Federal Law provides that a person who obtains credit information under false pretenses shall be fined or imprisoned not more than two years or both. Furthermore, I certify that, if I am receiving my spouse’s credit report, I am married to the person and receiving it with his or her knowledge or consent. Please Note: The generation of this report is for educational purposes andwill result in an inquiry on your credit file. |  |\n| CLIENT SIGNATURE | SPOUSE’S SIGNATURE (only if you are requesting a report for your spouse) |\n| DATE | DATE |\n| PHONE | PHONE |\n\n\n| Fees |  |\n| --- | --- |\n| There is a $12 fee for each credit report accessed. Please check the box to identify who the report is for: | 􀁑 Me ($12) 􀁑 My spouse and me ($24) |\n\n\n| Payment |  |  |\n| --- | --- | --- |\n| 􀁑 Credit card | CARD TYPE\u003Cbr>􀁑 Visa 􀁑 MasterCard 􀁑 American Express |  |\n|  | CARD NUMBER | EXP. DATE |\n|  | CARDHOLDER’S SIGNATURE | AMOUNT TO BE CHARGED |\n| 􀁑 Check or Money Order | Please make check/money order to: BALANCE, and mail to 595 Market Street, 16th Floor, San Francisco, CA 94105 |  |\n\nBALANCE • 595 MARKET STREET, 16TH FLOOR, SAN FRANCISCO, CA 94105 • 888.456.2227 • 415.777.4065 FAX • WWW. BALANCEPRO. NET","cbCaijyAfev4qLwa","https://ap.wps.com/l/cbCaijyAfev4qLwa","pdf",83642,"English","# Your Information\n## Personal Details\n## Spouse Information\n# Authorizing Signature(s)\n## Legal Acknowledgement\n## Client Signatures\n# Fees and Payment\n## Fee Schedule\n## Payment Methods","[{\"question\":\"What is the fee for accessing a credit report?\",\"answer\":\"There is a fee of $12 for each individual credit report accessed through the BALANCE program.\"},{\"question\":\"What are the payment options provided on the form?\",\"answer\":\"Clients can pay via credit card (Visa, MasterCard, or American Express) or by submitting a check or money order made out to BALANCE.\"},{\"question\":\"Does requesting this report impact my credit file?\",\"answer\":\"Yes, the generation of this report is for educational purposes and will result in an inquiry appearing on your credit file.\"}]","Credit Report Authorization Form - BALANCE Financial Fitness Program | PDF",1789634266]