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CX – 3 MERGE

RMCR

Disputed Account Information (Con’t) Borrower’s Name _____________________________________________ Borrower’s Address ____________________________________________ Borrower’s City, State And Zip ____________________________________ Borrower’s Phone Number _______________________________________ To Whom It May Concern: I, ________________________________________________, Do Not Dispute The Account with ______________________________________________________ Account Number ___________________________________________________. Please Remove All Dispute Verbiage From My Account. ________________________________ ______________________ SIGNED DATE

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