Your Name(PRINT OR TYPE DO NOT SIGN)
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Dear CRA,
My name is xxxxx xxxxxx , my SS # is xxx xx xxxx.
I am sending this dispute with proof of delivery mail receipt # xxxx to make sure you receive it.
I have no knowledge or records of account # xxxxx on my report # xxxxx.
I have disputed this unknown medical account with the reporting Collection Agent,( copy enclosed with proof of their receipt),as per your instructions in your response of xx/xx/xxxx
to my dispute of xx/xx/xxxx and have had no valid response.
Please advise me as to the name and address of the health care provider, the name of the patient,
and the reported date of service,as any account I might have had at one time would be obsolete.
Please be advised that I am exercising my rights under FCRA 611(a)(6)(B(iii) which provides that a consumer may request “a description of the procedure used to determine the accuracy and completeness of the information shall be provided to the consumer by the agency, including the business name and address of any furnisher of information contacted in connection with such information and the telephone number of such furnisher, if reasonably available.”
If you can obtain this information, I also would need the name of the person providing this data,
and the manner in which it was provided in order that I may pursue additional legal remedies.
If you are unable to verify and refuse to delete, I will be filing appropriate complaints against you
with the CFPB for FCRA and FACTA violations,the OCR for HIPAA violations and appropriate State authorities. Please
note that as a recipient of private medical data you are also subject to the provisions of subtitle D of the ARRA ,SEC. 13407(1) BREACH OF SECURITY.—The term ‘‘breach of security’’
means, with respect to unsecured PHR identifiable health
information of an individual in a personal health record,
acquisition of such information without the authorization of
the individual.
Please note that the effective enforcement of penalties against you for this breach is under the penalty rules
of the Omnibus Final Rule effective 09/23/2013
interpreting and implementing various provisions of the Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH Act)
as issued 11/30/2009 .Additionally your Credit Reporting Agency is now subject to Federal consumer financial laws, including, among others,
the FCRA and Title X of the Dodd-Frank Act, and related regulations including a ban on “Abusive” Acts or Practices.
( Section 1031 of the Dodd-Frank Act )
.
I also reserve the right to include your Bureau in any legal remedies
I pursue.
Very truly yours,
xxxxxx