Sample Adverse Action Letter: FCRA Final Notice for Employers
This sample adverse action letter tells an applicant about your final decision after a background check.
Send it only after the pre-adverse action letter and a fair wait. Therefore, review the sample and the rules below.
Sample only: This letter is a starting point, not legal advice. Therefore, ask your legal counsel to review it before use.
What a Sample Adverse Action Letter Shows
An adverse action letter is the final written notice of a negative employment decision.
Specifically, the decision rests in whole or in part on a background check report.
The Fair Credit Reporting Act (FCRA) sets what the notice must say (15 U.S.C. § 1681m).
Therefore, this sample adverse action letter follows that list.
Importantly, it comes after the pre-adverse action letter.
Otherwise, the applicant never gets a chance to respond.
What a Sample Adverse Action Letter Must Include
The FCRA lists four statements for every final notice (FTC guide for employers). Moreover, a credit score adds a fifth.
Required by the FCRA
- The name, address and phone number of the screening agency.
- A statement that the agency did not make the decision and cannot explain it.
- Notice of the right to dispute the accuracy or completeness of the report.
- Notice of the right to a free copy of the report within 60 days.
- Additionally, the credit score details, if you used a credit score.
Helpful additions
- The date of your pre-adverse action letter.
- A second copy of the report and the Summary of Rights.
- Also, any state or city notice that applies.
- Finally, a contact at your company for questions.
Sample Adverse Action Letter
Read the full sample below. In addition, each blank line shows where the employer adds its details.
Notice of Adverse Action
Sample letter
Date:
Applicant name:
Applicant address:
Dear :
On , (“the Company”) sent you a pre-adverse action notice. That notice included a copy of your consumer report and A Summary of Your Rights Under the Fair Credit Reporting Act. Copies are enclosed again for your records.
The Company has now decided not to offer you employment at this time. The Company based this decision in whole or in part on information in the consumer report.
The following consumer reporting agency provided the report:
BCS Background Screening LLC, 1172 South Dixie Hwy #257, Coral Gables, FL 33146. Telephone (800) 661-0278. https://usabackground.com
The consumer reporting agency did not make this decision and cannot give you the specific reasons for it.
You have the right to dispute the accuracy or completeness of any information in the report directly with the consumer reporting agency. If the report is a credit report, you may also contact the credit bureau that furnished it.
You also have the right to obtain a free copy of your report from the consumer reporting agency. You must request it within 60 days of receiving this notice.
Credit score information
Include only if the Company used a credit score
Your credit score: Date: Range of possible scores:
Key factors that adversely affected your score:
Score provided by:
California applicants or employees only
Applies only if the report is a credit report
You have the right to obtain a free copy of your credit report within 60 days from the consumer credit reporting agency identified on this notice, and from any other consumer credit reporting agency that compiles and maintains files on consumers on a nationwide basis. Under California law, you also have the right to dispute with the consumer reporting agency the accuracy or completeness of any information in the report.
If you have notified a consumer credit reporting agency in writing that you dispute the accuracy of information in your file, the agency must then, within thirty business days, reinvestigate and modify or remove inaccurate information. The consumer credit reporting agency may not charge a fee for this service. If reinvestigation does not resolve the dispute to your satisfaction, you may send a letter to the consumer credit reporting agency, to be kept in your file, explaining why you think the record is inaccurate. The consumer credit reporting agency must include your statement about the disputed information in a report it issues about you.
New York applicants or employees only
A copy of Article 23-A of the New York Correction Law is enclosed.
Sincerely,
Human Resources Department
Company name:
Company address:
Enclosures: Copy of your consumer report. A Summary of Your Rights Under the Fair Credit Reporting Act. Article 23-A of the New York Correction Law, if applicable.
– End of Document –
Sample letter by BCS Background Screening LLC. Updated October 2026.
Enclosures for the Adverse Action Letter
The FCRA requires no enclosure with the final notice. However, these copies help the applicant and your records.
| Enclosure | When to include it | Where to get it |
|---|---|---|
| Copy of the consumer report | Recommended. The applicant already received one. | Download it from your secure account. |
| Summary of Your Rights | Recommended. Use the current version. | Use the current CFPB form. |
| Summary of Rights in Spanish | When the applicant prefers Spanish. | Also use the CFPB Spanish form. |
| State or city notice | When a fair chance law applies. | Check our state and city rules. |
| Article 23-A copy | For New York reports that show a conviction. | See N.Y. Gen. Bus. Law § 380-g. |
When to Send the Adverse Action Letter
- 1
Confirm the Wait Is Over
First, check that the response period has ended.
Also, use the longest period that applies.
- 2
Review Any Response
Next, read any dispute or explanation from the applicant.
Additionally, document what you considered.
- 3
Send the Adverse Action Letter
Then, send the final notice in writing.
However, the FCRA also allows oral or electronic notice.
- 4
Keep Your Records
Finally, keep both letters and the dates you sent them.
Also, dispose of old reports securely.
From your secure account, you can generate a pre-populated adverse action letter with one click.
Then, print and mail it to your applicant for $5.00 per letter.
State and City Rules for the Adverse Action Letter
Fair chance laws also govern the final notice.
For example, California requires a written final notice after its response period.
Likewise, San Francisco requires the final notice within 30 days.
Meanwhile, Washington requires a written decision with your reasoning.
Therefore, check our state and city adverse action rules before you send.
Sample Adverse Action Letter: FAQs
What is an adverse action letter?
It is the final notice an employer sends after a negative decision based on a background check.
Moreover, it follows the pre-adverse action letter.
What must a sample adverse action letter include?
It must name the screening agency and give its address and phone number.
Additionally, it must say the agency did not make the decision.
Finally, it must explain the right to dispute and to request a free report within 60 days.
When should I send the adverse action letter?
Send it after the pre-adverse action letter and a reasonable wait.
Specifically, five business days is common practice, and some places require more.
Does the adverse action letter need to state the reason?
The FCRA does not require the specific reason.
However, some state and city laws require your reasoning in writing.
Can I skip the pre-adverse action letter?
No. The FCRA requires the pre-adverse action letter before any adverse action.
Otherwise, the applicant loses the chance to correct errors.
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Disclaimer: This sample letter offers general information, not legal advice. BCS Background Screening LLC does not assume responsibility for its compliant content. FCRA, state and local rules change, so consult legal counsel before you use it.