Mail this completed form and any documentation to:
Consumer Loan*
TD Bank
P.O. Box 219
Lewiston, ME
04243-0219
Former Riverside Bank
Consumer Loan*
or Mortgage Loan**
TD Bank
P.O. Box 400
Fort Pierce, FL 34954
Mortgage Loan**
TD Bank
P.O. Box 218
Lewiston, ME
04243-0218
TD Bank VISA
Credit Card
TD Bank Credit Cards
P.O. Box 84037
Columbus, GA
31908-4037
Retail Card
(serviced by TD Bank)
TD Retail Card Services
P.O. Box 731
Mahwah, NJ 07430
Target Credit Card
(serviced by TD Bank)
TD Bank USA, N.A.
c/o Target Card Services
P.O. Box 9500
Minneapolis, MN 55440
Deposit Account
TD Bank
ATTN: ME100-36
P.O. Box 9547
Portland, ME 04112
Consumer Credit Report Dispute Form
Please Print.
Name Today’s Date
Address City/State/Zip
Phone Best Time to Contact You
(You will be called only if we require additional information).
Last 4 Digits of Social Security Number
Not required, however this will help to process your dispute.
Select the type of product associated with the information being disputed.
o Mortgage
o Personal Loan
o Home Equity Loan
o Auto Loan
o Home Equity Line of Credit
o Home Improvement Loan
o Credit Card
o Deposit Account (checking or savings)
What is the Account Number of the product associated with your dispute?
Please provide us with details on why you are disputing this information on your credit report:
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________
Check off any supporting documentation you are providing (if applicable). Providing documentation is not required, however this may help
process your dispute.
o Credit report showing item being disputed o Other (provide description on lines below)
o Receipts showing account was paid ________________________________________________________________________________
o Canceled checks showing account was paid ________________________________________________________________________________
You will receive a written response from TD Bank within 30 days of receipt of your dispute. Note: a delay may be experienced if the
dispute is not mailed to the specified address below.
Customer Signature: __________________________________________________________________________________
TD Bank, N.A.
19864-M (12/13)
*Consumer Loan = Personal loan, Auto Loan, Home Improvement, Home Equity Line of Credit
** Mortgage Loan = Mortgage, Home Equity Loan
BANK USE ONLY:
Store / Call Center
o SM was sent to:
Acitivity code: CRBR Route to: L000
Form received on: Customer contacted by:
Resolution:
