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Notice of Adverse Action: $25.00

The form may be used to notify an applicant that due to the results of a consumer report compiled about the applicant, the employer has opted not to hire the applicant. Under the Fair Credit Reporting Act, an employer who uses information from a Consumer Reporting Agency to take action against an applicant or employee -- such as denying an application for employment -- must notify the applicant/employee, and provide the applicant/employee with the name, address, and phone number of the Consumer Reporting Agency that provided the consumer report.

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