Free adverse action notice 02Free adverse action notice 02
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Sample documents should NOT be construed as legal advice, guidance or counsel. Employers should consult their own attorney about their compliance
responsibilities under the FCRA and applicable state law. Accurate Background LLC., expressly disclaims any warranties or responsibility or damages associated
with or arising out of information provided. Employers seeking credit reports must provide additional notices pursuant to state law.

ADVERSE ACTION NOTICE - SAMPLE 1
Date
NAME
ADDRESS
CITY, ST ZIP
Dear _______________________:

We regret to inform you that [Client] is unable to consider you further for an employment opportunity with
our organization and is rescinding the previous offer of employment extended to you.
This decision was based in whole or in part on information contained in a report from Accurate Background
LLC, 7515 Irvine Center Dr., Irvine, CA 92618, 800-216-8024, www.accuratebackground.com. A copy of this
report, a copy of A Summary of Your Rights Under the Fair Credit