SAMPLE (Must be on company letterhead)
PRELIMINARY
NOTICE OF ADVERSE ACTION
(Date)____________________________________
(Applicant
Name)________________________________________________________
(Applicant's
Address)_____________________________________________________
(City, State
ZIP)_________________________________________________________
Dear
(Applicant):
Enclosed is
a copy of Consumer Report or Investigative Consumer Report that was
requested by (company Name) in connection with your (application for
employment) (current employment.)
A
preliminary decision has been made to (not employ you) (not continue
your employment.)
This
preliminary decision was based, either in whole or in part, on the
information contained in your Consumer Report.
The Consumer
Report was used only for employment purposes and prepared for us by a
consumer reporting agency.
If you wish
to dispute any information in the report, please contact the
consumer reporting agency as listed below.
They will be
able to tell you how to contact the State, County, Municipality or other
repository source from whom the information was obtained so that you may
dispute the information you believe is incorrect directly with the
source of that information.
National Employment
Screening DBA
Premium Background Checks/
Background Check Services
Attention:
Employment Screening Services
P.O. Box
9718
Tavernier
Fl. 33070-9718
Phone:
(800) 459.3034
The
consumer-reporting agency listed above , National Employment
Screening/Premium Background Checks however, did not make the employment
decision and can not give you the reason(s) for it. Nor can they change
the records. This must be done by the government agency or entity that
provided the record.
If we do not
hear from you within (number of days, usually 3-5), our preliminary
decision will become final and (you will not be hired) (your employment
will be terminated.)
Sincerely,
___________________________________________________
(Company
Representative Name)
(Title)______________________________________________Date______________________________
