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Pre-Adverse Action Notice | Sample

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Pre-Adverse Action Notice | Sample

Updated June 22, 2023

A pre-adverse action notice is sent to an applicant during the hiring process to get additional information if an arrest or conviction is found in their consumer report. A copy of the report is given to the applicant to show precisely what was found. The applicant will be given an opportunity to respond, and afterward, the employer will make a final decision.

Laws – 15 U.S. Code § 1681d

Required Attachments (2)

The following must be attached to a pre-adverse action notice:

  1. Copy of the consumer report (background check)
  2. A Summary of Your Rights Under the Fair Credit Reporting Act

Table of Contents

How It Works (3 Steps)

1. Employer Gives Notice of Findings

employer signing job candidate's pre-adverse action notice

The employer gives a pre-adverse action notice that details what was found on the investigative report by the reporting agency.

It is required that the employer also attach the consumer report and A Summary of Your Rights Under the Fair Credit Reporting Act.

2. Applicant is Given a Chance to Respond

Calendar showing duration that applicant can respond

The applicant will usually have 5 to 10 days to respond to the employer’s request. It’s recommended the applicant respond as soon as possible and provide any evidence to support their claims.

3. Employer Makes a Final Decision

Employer gives thumbs up to hire applicant

The employer will receive the claims and decide whether to hire or reject the applicant.

Criminal Arrests

According to the Bureau of Justice Statistics, approximately 5.1% of all individuals will be imprisoned in their lifetime. Most individuals, if convicted, are convicted for misdemeanors and petty crimes.

Therefore, an explanation of the illegal behavior is a common request.

Sample

PRE-ADVERSE ACTION NOTICE

[COMPANY NAME]
[STREET ADDRESS]
[CITY, STATE]
[ZIP CODE]

Date: [DATE]

Dear [APPLICANT NAME],

Thank you for your employment interest with our organization. As part of our hiring process, we requested a consumer report in accordance with the Fair Credit Reporting Act (FCRA).

Although, some of the details found in your report may be a concern to our team. In accordance with your rights, a copy of the consumer report and “A Summary of Your Rights Under the Fair Credit and Reporting Act” are attached. A decision has not been made, and we would like to investigate more into this matter.

Furthermore, our organization would like to allow you to explain your side of the story and give us a better understanding of the events that occurred. If you could please respond to this request within [#] business days to provide better context, or if you believe the information is inaccurate or incomplete. If we do not hear from you, we will assume that you are no longer interested.

In addition, you have the right to dispute any of the information found in the consumer report by contacting the consumer reporting agency directly via the following methods:

Consumer Reporting Agency: [CONSUMER REPORTING AGENCY]
Telephone: [PHONE] (toll-free)
Mailing Address: [ADDRESS]

We look forward to your response and hope it can provide the necessary details and make a final decision on the employment position.

Sincerely,

_________________________

Print Name: [PRINT NAME]
Position / Title: [POSITION / TITLE]


YOUR RESPONSE: [APPLICANT’S RESPONSE]

I declare (or certify, verify, or state) under penalty of perjury that the foregoing is true and correct.

Signature: _____________________ Date: _____________

Print Name: _____________________

How to Write

Download: PDF, MS Word, OpenDocument

I. Header To Notice

(1) Entity Mailing Information. This notice must clearly identify its Sender at the onset. To this end, locate the set of lines in the upper left of the letter and utilize this area to record the entire legal name of the Sender. Make sure the name of this Entity is recorded precisely as it appears on its legal and government paperwork including any number(s), abbreviation(s), or punctuation that are considered a part of the Sender’s full name. Additionally, the mailing address where a response to this letter will be received should be produced on the remaining empty lines.

(2) Required Effective Date. Since this will be considered a notice that an issue exists in the Recipient’s background, the Sender (Entity) must attach a specific date to its execution. Furnish the date when the Sender wishes this letter to be considered an active inquiry made of the Recipient on the blank space labeled “Date.” This will also be found on the left.

II. Target Recipient

(3) Recipient Name. The Recipient’s full name must be reported to address this notice properly. This will be the Party whose background is being questioned as a result of an inquiry and who this notice will inform of a negative or concerning incident or record that exists in his or her background report. Produce the Recipient’s name immediately after the greeting word “Dear.”

III. Reason For Notice

(4) Response Deadline. This notice includes the language needed to inform the Recipient that an authorized background or credit report has yielded a negative result that presents a significant obstacle to the Sender’s ability to continue the Notice Recipient’s application process. Since this document must conform with all governing laws that may be in place over the Sender’s business and the concerned application process, the number of  business days given to the Recipient to respond must be determined by the Sender then supplied where requested. The response time allowed to the Recipient will begin with the date of his or her receipt of this notice and terminate once the reported number of days (excluding weekends and federal holidays) have passed.

IV. Required Disclosure Information

(5) Consumer Reporting Agency. Naturally, the Recipient will likely wish to review the source of the negative information reported, especially if he or she believes the report is erroneous or a violation of his or her rights. Therefore, the name of the Consumer Reporting Agency that has generated the concerned background report must be documented on the appropriately labeled line of this notice.

(6) CRA Contact Information. The business telephone number and the official mailing address of the Consumer Reporting Agency named above must be included for the use of the Recipient. Use the lines labeled “Telephone” and “Mailing Address” to present this information. Make surethe phone number listed here ensures that fairly immediate contact can be established between the Recipient and the Consumer Reporting Agency while the mailing address is one that can be used by the Recipient of this notice to formally (and reliably) contact the concerned CRA.

V. Notice Execution

(7) Sender Signature. The Sender of this notice will require that it is taken seriously especially if it is being sent in response to an application process that will have long-lasting effects on an organization or property. Therefore, the Sender must sign the line directly beneath the closing phrase “Sincerely.” This requirement may be satisfied by the an official Signature Representative of the Sender if the Sender of this Notice is an Entity (such as a Corporation or Organization).

(8) Sender Name. The full printed name of the Sender or, if applicable, the Sender’s Signature Representative must be displayed on the blank space beneath the signature line.

(9) Sender Title. The job title held by the Notice Sender with the Entity he or she is representing should be documented on the final line of his or her signature area.

VI. Notice Recipient Response

(10) Response To Notice. The second portion of this packet presents an area titled “Your Response,” where the Notice Recipient may formally explain or respond to the the background report that will potentially result in an adverse action regarding his or her application. As mentioned this must be accomplished within the time frame mentioned in the notice above (see Item (4)). Here, the reasons, circumstances, claims, or explanations the Recipient may wish the Sender to take in consideration should be plainly stated. Additionally, any attachments containing evidence to support the Recipient’s statement(s) should be included with this response using the provided area to identify each such attachment by referring to its source, title, and date. Many would strongly recommend that the Recipient consult with a professional (such as an Attorney) during the response process

VII. Recipient Testimonial Signature

(11) Signature Of Recipient. The Notice Recipient must testify that his or her response is accurate and true by signing his or her name.

(12) Recipient Name. The printed name of the Notice Recipient must be produced when he or she signs this response.

(13) Date Of Recipient Signature. As discussed, the Recipient’s response will be considered time-sensitive by the Sender. Thus, the Recipient must conclude his or her signature area with a record of the exact date he or she signed this response.