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ADVERSE CREDIT ACTION

ADVERSE CREDIT ACTION

(REQUEST FOR DENIAL REASON)

 

 

Date:  _________________________

 

To:  ___________________________                     From:  ________________________

       ___________________________                                      ________________________

 

 

On ______________________, I was notified that my application for credit dated __________________, was denied based upon information received by you from a source other than a consumer credit reporting agency.  Pursuant to my rights under the Fair Credit Reporting Act, Title 15, USC, Sec., 1681m (b), I hereby request that the nature of the information received by you be disclosed to me.

 

Please forward such information to me at the above address.

 

 

 

________________________________

Signature

 

 

 



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