Request For Disclosure of MIB Record Information
Are you requesting disclosure:
1. Because you received a letter from an insurance company advising you that your benefits were not issued as applied for (either assessed extra premium or denied coverage) and that the decision was influenced from information provided by MIB?
2. Because you received a letter from an insurance company advising you to obtain disclosure?
3. For someone else under Power of Attorney?
4. For someone else as their Legal Guardian?
5. For a minor?
6. For yourself and you reside in the United States or Canada?
7. For yourself but you DO NOT live in the United States or Canada?
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