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SAMPLE ADVERSE ACTION LETTER
[Date]
[Applicant’s name and address]
Re:

Application for Employment at [EMPLOYER]

Dear [Applicant’s Name]:
I am writing regarding your recent application for employment with [EMPLOYER]. As
you will recall on [Date], you were issued an offer of employment conditioned on successful
completion of, among other things, a satisfactory background check. Previously, you were
provided with a copy of the background generated by [BACKGROUND SERVICE] as part of
that process.
Unfortunately, due to information provided in that report, [EMPLOYER] is unable to
offer you employment. [If the reason for rejection is criminal history information: A
criminal conviction contained in the report was at least part of the reason for the rejection of your
application.]
Because you have been rejected based on information contained in the background
report, the Fair Credit Reporting Act entitles you to receive a copy of this report from
[BACKGROUND SERVICE] within 60 days. You also