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Sample of an Adverse Action Notice to be sent to a candidate
when you deny employment based in whole or in part on any information
in an ODM Report.
Church Letterhead
<Date>
<Candidate Name>
<Address>
<City, State, Zip>
Dear <name>:
As you authorized during your employment application process, <church
name> has recently completed a pre-employment background check
as part of the employee screening process. The purpose of this letter
is to inform you that there is information in the "investigative
consumer report" we received which, if accurate, would prevent
us from offering you employment at this time. A copy of the report
is enclosed.
If, after reviewing the report, (1) you believe that information
contained in it is inaccurate and/or (2) you want to know what information
in the report falls outside of our church guidelines, we ask that
you contact us directly within five days. Otherwise we will assume
that you no longer wish to pursue employment with us.
This report was furnished to us by Oxford Document Management (ODM),
655 Highway 10, Anoka, MN 55303. Phone number for them is 1-800-801-9114.
Please understand that while ODM provided the report from sources
they deem highly reliable, they did not make this decision, and
they are unable to provide you with the specific reason why we made
this decision.
Enclosed along with the report is a "Summary of Your Rights
Under the Fair Credit Reporting Act." Under the law you have
the right to dispute, directly with ODM, any information in this
report. They will reinvestigate the disputed information free of
charge and either record the current status of the disputed information
or delete the item(s) within 30 days of receiving your dispute.
If the information is found to be inaccurate or incomplete or cannot
be verified, they will promptly delete that item or modify it. They
will provide notification of the dispute to any person who provided
the information you dispute within five business days of receiving
your notice of dispute. The enclosed Summary provides additional
information about your rights.
You have the right to obtain an additional free copy of the enclosed
report if you request it from ODM within 60 days of when you receive
this notice.
Sincerely yours,
<church representative>
Enclosures: Background Report, Summary of Your Rights Under the
Fair Credit Reporting Act
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