Form preview

Get the free Adverse Action Letter

Get Form
This document is a sample adverse action letter informing an applicant of the decision to decline their application based on information obtained from consumer reports or other sources, while outlining
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign adverse action letter

Edit
Edit your adverse action letter form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your adverse action letter form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing adverse action letter online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Use the instructions below to start using our professional PDF editor:
1
Check your account. It's time to start your free trial.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit adverse action letter. Replace text, adding objects, rearranging pages, and more. Then select the Documents tab to combine, divide, lock or unlock the file.
4
Get your file. When you find your file in the docs list, click on its name and choose how you want to save it. To get the PDF, you can save it, send an email with it, or move it to the cloud.
With pdfFiller, it's always easy to deal with documents.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out adverse action letter

Illustration

How to fill out Adverse Action Letter

01
Identify the action that prompted the letter (e.g., denial of credit, employment, etc.).
02
Gather the necessary information, including the name of the consumer, the reasons for the adverse action, and the date the action was taken.
03
Include the name and address of the company that provided the credit/report.
04
Clearly state the adverse action taken and the specific reasons why it was taken.
05
Inform the consumer of their right to obtain a free copy of their credit report from the reporting agency.
06
Provide the contact information for the reporting agency.
07
Include a statement informing the consumer of their right to dispute the accuracy or completeness of any information in their credit report.
08
Sign and date the letter before sending it to the consumer.

Who needs Adverse Action Letter?

01
Lenders who deny credit applications based on credit reports.
02
Employers who decide not to hire a candidate based on background checks.
03
Insurance companies that take adverse action based on credit information.
04
Landlords who deny rental applications due to credit history.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.2
Satisfied
25 Votes

People Also Ask about

Simply, Regulation B requires an adverse action notice typically anytime a credit union takes “adverse action” against a member after receiving a “completed application.”
Dear [Applicant Name], We regret to inform you that based on our hiring criteria, we are unable to consider you further for an employment opportunity with our organization. This decision was made in part from the information we received from , our employment screening vendor.
Adverse action refers to a decision that negatively affects a current or potential employee based on information in a background check report. For example, if a background check uncovers disqualifying information about a job candidate and you choose not to hire them, that's considered adverse action.
If you have received a pre-adverse action letter that you believe is discriminatory, you should first try to resolve the matter with the employer. You can do this by writing a letter to the employer explaining why you believe the letter is discriminatory and asking them to reconsider their decision.
Federal law requires lenders to provide individuals with adverse action notices if their credit score is being adversely used against them (i.e. when turning down a loan or credit card application or charging a higher interest rate).
Dear [Applicant Name], We regret to inform you that based on our hiring criteria, we are unable to consider you further for an employment opportunity with our organization. This decision was made in part from the information we received from , our employment screening vendor.
An adverse action notice is to inform you that you have been denied credit, employment, insurance, or other benefits based on information in a credit report.
Once you receive an adverse action letter, you have 60 days to request a free copy of the report from the credit bureau that was used for your application. Use the contact information provided in your denial letter to make the request.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

An Adverse Action Letter is a notification provided to a consumer when a financial institution or lender takes an adverse action based on information in a consumer report, such as a credit report, which may include denying a loan or credit application.
Organizations such as banks, credit unions, and other lenders, as well as companies that use consumer reports for employment and other purposes, are required to send an Adverse Action Letter when they take adverse action based on the information in a consumer report.
To fill out an Adverse Action Letter, include the name and address of the consumer, the date of the letter, a statement that an adverse action was taken, a summary of the reasons for the action, the name and contact information of the consumer reporting agency, and the consumer's rights regarding the report.
The purpose of the Adverse Action Letter is to inform consumers of the adverse action taken against them, provide reasons for that action, and inform them of their rights, including the right to dispute inaccuracies in their credit report.
The Adverse Action Letter must include the nature of the adverse action, the specific reasons for the action, the identity of the consumer reporting agency that provided the credit report, the consumer's right to request a free copy of their report, and the right to dispute incorrect information.
Fill out your adverse action letter online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.