Adverse Employment Action Notice
Dear [insert applicant/employee s name],
As part of your application for employment with [Your company], you consented to an independent investigation conducted by a consumer reporting agency. This investigation may have included obtaining information up to the last seven years (10 years for bankruptcy information) regarding your credit background, references, character, past employment, work habits, education, general reputation, personal characteristics, mode of living, judgment, liens and criminal background.
[Your company] contracted with [insert name of the consumer reporting agency] whose address and telephone number are [insert address and telephone number, toll-free number if appropriate].
[Name of the consumer reporting agency] has reported to [Your company] the following information:
[Insert disqualifying information]
Based on this information, you would not be extended an offer of employment. [Name of the consumer reporting agency] has not made this decision and is not able to explain why the decision was made.
Enclosed is a copy of the report and a summary of your rights as a consumer under the Fair Credit Reporting Act. You have the right to obtain a free disclosure of your file from [name of the consumer reporting agency], if you request the report within 60 days. You also have the right to dispute directly with [name of the consumer reporting agency] the accuracy or completeness of any information provided by it.
If you believe the disqualifying information listed above is not accurate, please contact [insert the name and telephone number of the contact person at [Your company within two business days of receiving this letter. [Your company] will not make a final decision regarding your application until [insert date]. This will give you an opportunity to contact [Your company] if you want to dispute the report submitted by [name of the consumer reporting agency].
______________________________________ [signature]
______________________________________ [date]