July 22, 2017 (YOUR NAME)

(ADDRESS)
(ADDRESS)

(NAME OF CREDITOR)
(ADDRESS)
(ADDRESS)
Account #

REQUEST FOR AUDITED TRANSACTION HISTORY

I am requesting a transaction history in dispute for any returns, reversals, account not found, NSFs or any
other banking/transaction codes that deny my consent to your companies access related to my payments.
According to the EFT Act, I require a certified, verified and complete transaction history by jurat affidavit under
pains and penalty of perjury. I have been instructed by my bank if the funds are not applied to the account
and the transaction history is not provided as required to open a case with the IRS Criminal Investigation
Department, the US Treasury and the Secret Service for investigation of suspicious activity and to locate the
whereabouts of my funds. You are in violation of 15 U.S.C. 1693(f) and FDIC 6000 Consumer Protection;
TITLE VI ELECTRONIC FUND TRANSFERS 908 Error Resolution (e) Treble Damages will apply if the
reversal is not corrected within 10 days.

Confirmation Code #. for $. on 7-20-2017

Confirmation Code #. for $. on 7-17-2017

Confirmation Code #. for $. on 7-14-2017

Confirmation Code #. for $. on 7-12-2017

Respectfully submitted,
(YOUR NAME) All Rights Reserved with Prejudice.

(YOUR NAME)
(ADDRESS)
(ADDRESS)