* Plus State Court Fee
Sample Preliminary Adverse Action Letter
SAMPLE (Must be on company letterhead)
PRELIMINARY NOTICE OF ADVERSE ACTION
(City, State ZIP)_________________________________________________________
Enclosed is a copy of Consumer Report or Investigative Consumer Report that was requested by (company Name) in connection with your (application for employment) (current employment.)
Also enclosed is "A Summary of Your Rights Under the Fair Credit Reporting Act."
A preliminary decision has been made to (not employ you) (not continue your employment.)
This preliminary decision was based, either in whole or in part, on the information contained in your Consumer Report.
The Consumer Report was used only for employment purposes and prepared for us by a consumer reporting agency.
If you wish to dispute any information in the report, please contact the consumer reporting agency as listed below.
They will be able to tell you how to contact the State, County, Municipality or other repository source from whom the information was obtained so that you may dispute the information you believe is incorrect directly with the source of that information.
Screening Company Name:
Screening Company Address:
The consumer-reporting agency listed above did not make the employment decision and can not give you the reason(s) for it. Nor can they change the records. This must be done by the government agency or entity that provided the record.
If we do not hear from you within (number of days, usually 3-5), our preliminary decision will become final and (you will not be hired) (your employment will be terminated.)
(Company Representative Name)