FACTA Request (Fair and Accurate Credit Transaction Act)

As a victim of identity theft, The Fair and Accurate Credit Transaction Act (FACTA) entitles you to receive specific information pertaining to a disputed account/transaction under your personal information. To request information in accordance to the FACTA, please complete the following request.

Backend Form Name

GroupName

FileName

Subject

Is New Incident Attachment

NoYes

Account Owner Information

First Name

Last Name

Email Address

Contact Phone Number (10-Digits)

This field must contain 10 digits(s).

T-Mobile (or Metro) Account / Subscriber Number (9-Digits)

This field must contain 9 digits(s).

Street address Line 1

Street address Line 2

City

State

Zip

Supporting Document(s)

Label1

Label2

Label3

Attach Document(s)

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