Creditor Name    First Address Line  Second Address Line  (if needed) Third Address Line  (if needed) City State Zip Acct. No. (show full account number)  Started what year 2008 2006-2007 2004-2005 BEFORE 2004 VARIOUS Amount owed.  Whole dollars, no cents,  no periods, no dollar signs, no commas.  Example: if you owe $7,146.39, write 7146.     What for CREDIT CARD MEDICAL LOAN STUDENT LOAN UTILITY GOODS/SERVICES COLLECTION AGENCY LAW FIRM BUSINESS OTHER Your three initials (use your same initials for every creditor) Look up address