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The Adverse Action form is an essential document in the realm of consumer banking, providing a formal notification when a financial institution denies a request for a deposit account. This notice must clearly outline the reasons behind the decision, typically drawing from information sourced through consumer reporting agencies like Chex Systems. With a focus on transparency, the form informs applicants of their rights under the Fair Credit Reporting Act, which permits them to access their credit reports and dispute any inaccuracies they may encounter. Various templates exist, such as those including or excluding credit score disclosures, allowing institutions to tailor their communications to comply with legal requirements while addressing specific applicant needs. Moreover, Chex Systems offers helpful materials designed to guide institutions in adhering to compliance regulations, although it is crucial to note that the responsibility remains with each institution to ensure that these forms meet all applicable laws. The information provided is not customized to fit any one institution's practices, underscoring the importance of internal review for compliance.

Adverse Action Example

Chex Systems, Inc.

Notice of Adverse Action Form Samples

Release Date: January 2012

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

INFORMATION ABOUT THIS DOCUMENT

 

As a o e ie e, Che “ ste s, I . ChexSystems

a pro ide or other ise ake a aila le to its

customers certain sample adverse action forms, procedures, or other similar information (collectively, Materials . ChexSystems customers acknowledge and agree that the Materials were created for general

application and have not been customized to address usto ers’ specific business operations. ChexSystems does not guarantee that the Materials will comply with any applicable laws, rules or regulations, and the customer is responsible for its use of Materials and bears sole liability for any such use.

Samples in this document include:

1.ChexSystems Adverse Action Notice, without Credit Score Disclosure

2.ChexSystems Adverse Action Notice, with Credit Score Disclosure

3.ChexSystems, plus Credit Bureaus Adverse Action Notice, with Credit Score Disclosure

CHEXSYSTEMS POSITION ON THE CREDIT SCORE DISCLOSURE REQUIREMENT

ChexSystems is not taking a position on whether or not its customers are required to provide the Credit Score Disclosure to declined account applicants; rather, each financial institution is responsible for making this determination on its own behalf. As a convenience to its customers that elect to provide the Credit Score Disclosure to declined account applicants, ChexSystems is now making available the data fields necessary to support the Credit Score Disclosure requirements set forth by the Dodd-Frank Act. These additional data fields are provided in the ChexSystems QualiFile electronic inquiry response.

Chex Systems, Inc. (herein ChexSystems) is a consumer reporting agency and

an indirect wholly owned subsidiary of Fidelity National Information Services, Inc.

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

Notice of Adverse Action

Notice Date:

We are sorry but we are unable to accommodate your request to open a deposit account with our institution at this time. Our decision was based in whole or in part on information obtained in a report from the consumer reporting agency listed below. You have a right under the Fair Credit Reporting Act to know the information contained in your file at the consumer reporting agency. The reporting agency played no part in our decision and is unable to supply specific reasons why we have denied your request to open a deposit account in our institution. You also have a right to a free copy of your report from the reporting agency, if you request it no later than 60 days after you receive this notice. In addition, if you find that any information contained in the report you receive is inaccurate or incomplete, you have the right to dispute the matter with the reporting agency.

Chex Systems, Inc.

Attn: Consumer Relations

7805 Hudson Road, Suite 100

Woodbury, MN 55125

Telephone: 800-428-9623

Fax: 602-659-2197

Web: www.consumerdebit.com

If you have any questions regarding your consumer report, you should contact the consumer reporting agency using the contact information above.

If you have any other questions regarding this notice, you should contact:

Institution name:

Institution address:

Institution toll-free telephone number:

As a convenience, Chex may provide or otherwise make available to Client certain sample adverse action forms, procedures, or other similar information (collectively,

Materials ). Clie t a k o ledges a d agrees that the Materials ere reated for ge eral appli atio a d ha e ot ee usto ized to address Clie t’s spe ifi business operations. Chex does not guarantee that the Materials will comply with any applicable laws, rules or regulations, and Client is responsible for its use of Materials and bears sole liability for any such use.

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

Notice of Adverse Action

Notice Date:

We are sorry but we are unable to accommodate your request to open a deposit account with our institution at this time. Our decision was based in whole or in part on information obtained in a report from the consumer reporting agency listed below. You have a right under the Fair Credit Reporting Act to know the information contained in your file at the consumer reporting agency. The reporting agency played no part in our decision and is unable to supply specific reasons why we have denied your request to open a deposit account in our institution. You also have a right to a free copy of your report from the reporting agency, if you request it no later than 60 days after you receive this notice. In addition, if you find that any information contained in the report you receive is inaccurate or incomplete, you have the right to dispute the matter with the reporting agency.

Chex Systems, Inc.

Attn: Consumer Relations

7805 Hudson Road, Suite 100

Woodbury, MN 55125

Telephone: 800-428-9623

Fax: 602-659-2197

Web: www.consumerdebit.com

We also obtained your credit score from this consumer reporting agency and used it in making our credit decision. Your credit score is a number that reflects the information in your consumer report. Your credit score can change, depending on how the information in your consumer report changes.

Credit Score:

 

Score Date:

Scores range from a low of 100 to a high of 9999

Key factors that adversely affected your credit score (insert here the four key factors that adversely affected the credit score or if the number of recent inquiries is a key factor, insert five key factors including the number of recent inquiries):

If you have any questions regarding your credit score, you should contact the consumer reporting agency using the contact information above.

If you have any other questions regarding this notice, you should contact:

Institution name:

Institution address:

Institution toll-free telephone number:

As a convenience, Chex may provide or otherwise make available to Client certain sample adverse action forms, procedures, or other similar information (collectively,

Materials ). Clie t a k o ledges a d agrees that the Materials ere reated for ge eral appli atio a d ha e ot ee usto ized to address Clie t’s spe ifi

business operations. Chex does not guarantee that the Materials will comply with any applicable laws, rules or regulations, and Client is responsible for its use of Materials and bears sole liability for any such use.

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

Notice of Adverse Action

Notice Date:

We are sorry but we are unable to accommodate your request to open a deposit account with our institution at this time. Our decision was based in whole or in part on information obtained in a report from one or more of the consumer reporting agencies listed below. You have a right under the Fair Credit Reporting Act to know the information contained in your file at the consumer reporting agency. The reporting agency played no part in our decision and is unable to supply specific reasons why we have denied your request to open a deposit account in our institution. You also have a right to a free copy of your report from the reporting agency, if you request it no later than 60 days after you receive this notice. In addition, if you find that any information contained in the report you receive is inaccurate or incomplete, you have the right to dispute the matter with the reporting agency.

 

 

ChexSystems

 

 

Experian

 

 

Equifax

 

 

Trans Union

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Chex Systems, Inc.

Experian

Equifax Credit Information Services

TransUnion Consumer Relations

Attn: Consumer Relations

PO Box 2002

PO Box 740241

PO Box 1000

7805 Hudson Road, Suite 100

Allen, TX 75013

Atlanta, GA 30374

Chester, PA 19022

Woodbury, MN 55125

 

 

 

 

 

 

 

 

 

 

 

 

Telephone: 888-397-3742

Telephone: 800-685-1111

Telephone: 800-888-4213

Telephone: 800-428-9623

Web:

 

 

 

Web:

Fax: 602-659-2197

www.experian.com/reportaccess

 

 

 

www.transunion.com/myoptions

Web: www.consumerdebit.com

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

To contact ChexSystems in

If you prefer to use a mailed

To contact Equifax in writing,

If you prefer to mail a request,

writing, forward your request

request, send the following

forward your request including

please provide your first name,

including your full name,

information to Experian: your full

your name, address, former

last name, middle initial, current

including middle initial, current

name, including middle initial and

address (if you have been at your

address, Social Security number,

address, US Social Security

generation such as SR, JR, II, etc.;

current address less than two

date of birth, any previous

number, date of birth and any

current mailing address; Social

years), Social Security Number

addresses used in the past five

previous addresses used in the

Security number; date of birth;

(required) and the name of the

years (include any PO Boxes).

last five years (including PO

previous addresses for the past

company that referred you to

 

 

 

Boxes).

two years; and two proofs of your

Equifax.

 

 

 

 

 

 

current mailing address, such as

 

 

 

 

 

 

 

 

 

dri er’s li e se, utilit ill, a k or

 

 

 

 

 

 

 

 

 

insurance statement, etc.

 

 

 

 

 

 

As a convenience,

Chex may provide or otherwise make available to Client certain sample adverse action forms, procedures, or other similar information (collectively,

Materials ). Clie

t a k o ledges a d agrees that the Materials ere reated for ge eral appli atio a d ha e ot ee usto ized to address Clie t’s spe ifi

business operations. Chex does not guarantee that the Materials will comply with any applicable laws, rules or regulations, and Client is responsible for its use of Materials and bears sole liability for any such use.

Sample Form Continues on Next Page….

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

We also obtained your credit score from this consumer reporting agency and used it in making our credit decision. Your credit score is a number that reflects the information in your consumer report. Your credit score can change, depending on how the information in your consumer report changes.

Credit Score:

 

Score Date:

Scores range from a low of 100 to a high of 9999

Key factors that adversely affected your credit score (insert here the four key factors that adversely affected the credit score or if the number of recent inquiries is a key factor, insert five key factors including the number of recent inquiries):

If you have any questions regarding your credit score, you should contact the consumer reporting agency using the contact information above.

If you have any other questions regarding this notice, you should contact:

Institution name:

Institution address:

Institution toll-free telephone number:

As a convenience, Chex may provide or otherwise make available to Client certain sample adverse action forms, procedures, or other similar information (collectively,

Materials ). Clie t a k o ledges a d agrees that the Materials ere reated for ge eral appli atio a d ha e ot ee usto ized to address Clie t’s spe ifi business operations. Chex does not guarantee that the Materials will comply with any applicable laws, rules or regulations, and Client is responsible for its use of Materials and bears sole liability for any such use.

Contact Us

For more information about Risk, Fraud, and Compliance Solutions

 

e-mail us at:

[email protected]

 

or visit us on the Web:

www.fisglobal.com/products-riskfraudcompliance

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Chex Systems, Inc. Notice of Adverse Action Form Samples (Release Date: January 2012)

 

Copyright © 2012 Fidelity National Information Services and/or its subsidiaries. All Rights Reserved.

 

File Breakdown

Fact Name Description
Purpose of the Form The Adverse Action form informs individuals when their application for a deposit account has been denied due to information obtained from a consumer reporting agency.
Rights of the Consumer Consumers have the right to know the information contained in their file at the reporting agency and may request a free copy of their report within 60 days of receiving the notice.
Credit Score Disclosure The form may include a disclosure about the applicant's credit score, which can affect the decision to grant an account. Institutions must determine if they are required to provide this information under the Dodd-Frank Act.
Legal Compliance ChexSystems provides sample adverse action forms, but these are not guaranteed to comply with specific laws or regulations. Institutions are responsible for their own compliance.

Guide to Using Adverse Action

Completing the Adverse Action form is a straightforward process that helps ensure compliance with relevant regulations. After filling out the form, it will be sent to the applicant to inform them of the decision regarding their account request. Below are the steps you need to follow to fill out the form correctly.

  1. Obtain the Form: Download or print a copy of the Adverse Action form from the specified source.
  2. Fill in the Notice Date: Write the date on which you are sending the notice.
  3. Explain the Decision: Clearly state that the application to open a deposit account has been denied.
  4. Identify the Source: Include the name of the consumer reporting agency that provided the information used for the decision.
  5. Include Consumer Rights: Remind the applicant of their rights under the Fair Credit Reporting Act, including the right to obtain a free copy of their report.
  6. Provide Contact Information: List the contact details of the consumer reporting agency, including their address, telephone number, and website.
  7. Credit Score Information: If applicable, mention whether a credit score was obtained and include the score itself along with the date it was given.
  8. List Key Factors: Describe the key factors that negatively affected the applicant's credit score, if relevant.
  9. Institution Information: Fill in your institution's name, address, and toll-free telephone number for further inquiries.
  10. Review for Accuracy: Check that all the information provided is accurate and complete before sending it out.

Get Answers on Adverse Action

  1. What is an Adverse Action Form?

    An Adverse Action Form is a document used by financial institutions to notify an individual that their application for a deposit account or credit has been denied. This form provides information about the decision-making process and informs the applicant of their rights under the Fair Credit Reporting Act.

  2. Why might I receive an Adverse Action Form?

    You may receive this form if your application for a bank account, loan, or credit card was denied based on information from a consumer reporting agency, such as ChexSystems. The institution must inform you of this decision in accordance with legal requirements.

  3. What information is included in the Adverse Action Form?

    The form typically includes:

    • The reason for the denial.
    • The name of the consumer reporting agency that provided the report.
    • Your rights under the Fair Credit Reporting Act.
    • Instructions on how to dispute any inaccuracies in the report.
  4. Do I have the right to my consumer report?

    Yes, under the Fair Credit Reporting Act, you have the right to request a free copy of your consumer report from the reporting agency within 60 days of receiving the Adverse Action Form. This allows you to review the information that influenced the denial.

  5. What should I do if I believe my report is inaccurate?

    If you find inaccuracies, you can dispute the information directly with the consumer reporting agency. The agency is required to investigate the dispute and correct any errors if they are validated.

  6. What is the significance of the credit score disclosure?

    The credit score disclosure, when included, informs you of your credit score used in the decision-making process. It may also include key factors that adversely affected your score. Understanding this can help you identify areas for improvement in your credit profile.

  7. Are all financial institutions required to use an Adverse Action Form?

    Not all institutions are legally required to use a specific Adverse Action Form. However, they must provide some form of communication regarding the denial and inform applicants of their rights.

  8. Can I appeal a decision made based on the Adverse Action Form?

    While the form itself does not provide an official avenue for appeal, you can contact the financial institution to understand their policies regarding reconsideration or to check if additional documentation can support your application.

  9. What is ChexSystems' role in the Adverse Action process?

    ChexSystems functions as a consumer reporting agency that provides information to financial institutions regarding an individual's banking history. Institutions may use this information to make credit decisions, leading to the issuance of an Adverse Action Form if an application is denied.

  10. How can I contact ChexSystems for more information?

    You can reach ChexSystems' Consumer Relations team at 800-428-9623 or via their website at www.consumerdebit.com for any inquiries related to your consumer report or the Adverse Action Form.

Common mistakes

Completing the Adverse Action form may seem straightforward, but there are common pitfalls that can lead to complications. One frequent mistake is failing to include the necessary information about the consumer reporting agency used in the decision-making process. The law requires that consumers are informed about which agency provided the information influencing their application. Omitting this detail can leave applicants confused and may expose institutions to compliance issues.

Another common error is neglecting to provide the correct reasons for the adverse action. While institutions often use sample templates, it’s crucial to tailor the reasons to the specific situation of the applicant. Generic statements or vague language fail to meet legal disclosure requirements and can lead to credibility issues. Each applicant deserves clarity regarding why their application was denied to avoid misunderstandings.

Many institutions also forget to include the required timelines for the applicant to request their consumer report. If the notice doesn’t specify the 60-day window within which the applicant can request their report, it can undermine their right to access their information. This oversight not only frustrates consumers but also puts the institution at risk of regulatory scrutiny.

A final crucial mistake involves the mishandling of credit score disclosure. Institutions that are required to disclose credit scores may not provide adequate key factors that adversely affected the score. Including vague or unclear factors does not serve the applicants’ interests. Clear and specific information about key factors helps consumers understand their credit situations and empowers them to make informed decisions moving forward.

Documents used along the form

In the context of the Adverse Action process, several other important documents accompany the Adverse Action form. Each of these documents helps ensure compliance with regulations and provides consumers with essential information. Familiarity with these forms is crucial for financial institutions and their clients.

  • ChexSystems Adverse Action Notice: This document outlines the reason for denying a request to open a deposit account, citing information from a consumer reporting agency.
  • Credit Score Disclosure: This form provides the consumer with their credit score and details the factors that negatively impacted that score, fulfilling requirements under the Fair Credit Reporting Act.
  • Notice of Rights: This informs the consumer of their rights concerning their consumer report, including the right to dispute inaccuracies.
  • Consumer Reporting Agency Contact Information: This includes details on how a consumer can obtain a copy of their report from the reporting agency.
  • Adverse Action Policy Sample: A template outlining the institution’s procedures for handling adverse actions, which helps ensure consistency and compliance with legal standards.
  • Documentation of Decision-Making Process: This internal record shows how the decision to deny credit was made, protecting the institution if the decision is questioned.
  • Training Materials for Staff: Resources designed to educate staff on proper procedures and legal obligations related to adverse actions.

Together, these documents facilitate transparency, support compliance, and protect both consumers and institutions during the adverse action process. Proper management of these materials can help maintain trust and uphold regulatory standards.

Similar forms

  • Credit Denial Letter: Similar to the Adverse Action form, a credit denial letter informs applicants of the decision to deny credit based on their credit report. It provides reasons for the denial and details about their rights.
  • Risk-Based Pricing Notice: This document notifies consumers when they receive less favorable terms due to credit risk. Like the Adverse Action form, it explains the influence of their credit score on the credit decision.
  • Consumer Report Disclosure: This document offers consumers information regarding how their credit report was used in making lending decisions. It emphasizes consumers' rights to review their reports, similar to the rights outlined in the Adverse Action form.
  • Adverse Action Notice for Employment: This notice details an employer's decision to not hire an applicant based on their background check. It shares similarities with the Adverse Action form by outlining the reasons for the decision and consumer rights.
  • FCRA Summary of Rights: This summary highlights the rights of consumers under the Fair Credit Reporting Act, helping them understand their rights similar to how the Adverse Action form does.
  • Notice of Dispute Rights: This document informs consumers of their right to dispute inaccurate or incomplete information on their report. It echoes the Adverse Action form's emphasis on a consumer's ability to address concerns about their credit report.
  • Service Denial Notice: This notice communicates the decision to deny services, explaining the reasons that led to this conclusion. It parallels the Adverse Action form by informing consumers and providing necessary details.

Dos and Don'ts

When completing the Adverse Action form, consider the following guidelines:

  • Do provide accurate information about the decision-making process, including details on the consumer reporting agency used.
  • Do include your contact information for the individual or department that the applicant can reach out to with questions.
  • Do mention the applicant's credit score if relevant, along with the date it was obtained.
  • Do specify the key factors that led to the adverse decision to help the consumer understand the reasoning.
  • Do ensure timely delivery of the notice, within the required time frame after the decision is made.
  • Don’t omit important details about the applicant's rights under the Fair Credit Reporting Act.
  • Don’t use vague language that can confuse the recipient; be clear about the reasons for the adverse action.
  • Don’t include unnecessary information that might not be relevant to the specific action taken.
  • Don’t fail to review the form for errors before sending it to ensure compliance with legal requirements.
  • Don’t forget to mention the right to obtain a free copy of the report and the process to dispute inaccuracies.

Misconceptions

  • Misconception 1: The Adverse Action form is only necessary when denying a credit application.
  • This form is required whenever an application is denied based on information from a consumer reporting agency, regardless of the context, such as opening a deposit account.

  • Misconception 2: If my application is denied, I won't receive any follow-up communication.
  • The Adverse Action form serves as an official notification. You will receive this notice explaining why your request was denied and your rights to dispute any erroneous information.

  • Misconception 3: It's unnecessary to provide a reason for the adverse action.
  • The form must indicate that your decision was influenced by the information obtained from a consumer reporting agency. This transparency is essential for compliance.

  • Misconception 4: Consumers cannot dispute the information used in the adverse decision.
  • You have the right to dispute any inaccuracies in the consumer report that influenced the adverse action. The notice instructs you on how to do this.

  • Misconception 5: The credit score is not a significant factor in adverse actions.
  • Misconception 6: ChexSystems is responsible for the adverse decision.
  • The consumer reporting agency merely provides information. Your financial institution makes the final decision, which must be communicated to you through the Adverse Action form.

  • Misconception 7: There is no timeline for receiving the Adverse Action notice.
  • You should receive the notice promptly after a decision is made. Timely communication is a requirement under the law.

Key takeaways

When dealing with the Adverse Action form, keep these key takeaways in mind:

  • Ensure that the form you are using is appropriately tailored to your institution's needs. ChexSystems provides sample forms, but they are general and may not fit every business operation.
  • Remember that you are responsible for compliance. ChexSystems cannot guarantee that the materials will meet all applicable laws or regulations.
  • Inform applicants of their rights under the Fair Credit Reporting Act. This includes their right to know how their credit report influenced the decision and their right to dispute any inaccuracies.
  • If you use the Credit Score Disclosure, make sure to include accurate information about the applicant's credit score and the key factors that affected it.