# Adverse Action Notice: Free Landlord Template (2026)

- Link: https://clearlegaltips.com/adverse-action-notice-template/
- Published: 2026-07-18T06:21:38-04:00
- Author: ClearLegalTips

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## Download This Resource

Download the free adverse action notice: a fillable PDF and editable DOCX with the
three trigger variants (denial, tougher terms, withdrawn offer), the screening-agency
contact block, the mandatory who-decided statement, the 60-day free-copy and dispute
rights, and a delivery record, plus a landlord checklist that runs from the screening
report to the filed copy.

[📄Fillable PDFPrint & complete](https://clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-document-1.pdf)
[📝Editable DOCXFill in your details](https://clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-document-1.docx)
[✅Action ChecklistStep-by-step PDF](https://clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-checklist-1.pdf)

**The short version (2026):** Deny a rental application because of a tenant screening
report, or approve it on tougher terms, and federal law hands you homework: the 
adverse action notice the Fair Credit Reporting Act requires. Inside it go the screening
company’s name, address, and phone number, a statement that the company did not 
make the decision, and the applicant’s two rights, a free copy of the report within
60 days and a dispute path for whatever is in it. Flat rejections are not the whole
territory either; a bigger deposit or a required co-signer counts. Few small landlords
have ever sent one, which is why the template below exists.

Most landlords’ rejection email runs two sentences and sounds harmless. “Thanks 
for applying. We’ve decided to go with another applicant.” If the decision leaned
on a tenant screening report, that friendly little email is a federal compliance
failure, and the landlord who sent it usually has no idea a rule was involved at
all.

That rule is the Fair Credit Reporting Act, the same statute governing the credit
pull itself, and once stated, its logic is hard to argue with. Somebody’s file was
judged on a report they have never seen. Maybe the report was right. Maybe it confused
them with a different tenant or attached someone else’s eviction; maybe a paid debt
shows open. Which of those happened is what the adverse action notice lets the applicant
discover: a report was used, this company compiled it, here is the path to a free
copy and a challenge.

On this page: when the duty triggers, the four required contents, a free adverse
action notice template to copy, and the two conditional-approval situations, the
bigger deposit and the required co-signer, that landlords almost never recognize
as adverse action.

## What an adverse action notice is

![What an adverse action notice is: the FCRA-required message a landlord sends after
a tenant screening report influences a rental decision](https://i0.wp.com/clearlegaltips.
com/wp-content/uploads/2026/07/adverse-action-notice-01-what-it-is.jpg?w=1290&ssl
=1)

Strictly speaking, an adverse action notice is the message a landlord owes after
taking action against an applicant based on a consumer report, and in rental practice
that report is the [tenant screening report](https://clearlegaltips.com/tenant-screening-report-cost-comparison/):
credit, eviction history, criminal records, whatever the screening service compiled.
Its home is 15 U.S.C. 1681m, and the duty attaches to whoever used the report, meaning
the landlord, not the screening company that sold it.

The statute is more flexible about form than people expect. Under [1681m(a)](https://www.law.cornell.edu/uscode/text/15/1681m),
the user of the report must provide oral, written, or electronic notice of the adverse
action to the consumer. An email qualifies; a phone call technically qualifies. 
Written or electronic is the only sensible choice all the same, because a landlord
who gave oral notice owns the burden of proving it years later, and a dated letter
proves itself.

What trips people up is not the form but the trigger. The notice is owed whenever
the report influenced the outcome, even partially. A landlord who rejected an applicant
for three reasons, one of them the screening report, owes the notice as surely as
one who rejected on the report alone.

## “Adverse action” is bigger than a rejection

![Adverse action is bigger than a rejection: requiring a co-signer or a larger deposit
because of the screening report counts under the FCRA and FTC guidance](https://
i0.wp.com/clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-02-
bigger-than-denial.jpg?w=1290&ssl=1)

The definition is the part of this law most worth reading twice. The FCRA defines
adverse action expansively in [15 U.S.C. 1681a(k)](https://www.law.cornell.edu/uscode/text/15/1681a):
beyond denials and cancellations, it reaches an increase in any charge for, or any
other adverse or unfavorable change in the terms of, a benefit, and its residual
clause sweeps in any determination adverse to the interests of the consumer. Rental
housing sits comfortably inside that language.

The FTC’s [landlord guidance](https://www.ftc.gov/business-guidance/resources/using-consumer-reports-what-landlords-need-know)
turns the abstraction into a checklist, and two of its examples surprise nearly 
everyone. Requiring a co-signer on the lease, when the screening report drove the
requirement, is adverse action. So is requiring a deposit that would not be required
for another applicant. The approval letter that says “we’d love to have you, with
a guarantor and a double deposit” feels like good news to the landlord writing it;
under the FCRA it is an adverse action, and the notice is owed alongside it.

That connects this page to two of its neighbors. When a thin screening report leads
you to require a [co-signer agreement](https://clearlegaltips.com/lease-co-signer-agreement/),
send the adverse action notice with the guaranty paperwork. When it leads you to
ask for a larger deposit, check the [state deposit cap](https://clearlegaltips.com/security-deposit-limits-by-state/)
first, then send the notice with the revised offer. The notice does not make the
conditional approval hostile; it makes it legal.

## The four things the notice must contain

![The four required elements of an adverse action notice: the screening agency's
contact details, the who-decided statement, the 60-day free-copy right, and the 
dispute right](https://i0.wp.com/clearlegaltips.com/wp-content/uploads/2026/07/adverse-
action-notice-03-four-elements.jpg?w=1290&ssl=1)

The FCRA adverse action requirements live in section 1681m(a), and they are mercifully
concrete. The screening company’s identity comes with full contact details: the 
name, address, and telephone number of the consumer reporting agency that furnished
the report, including the toll-free number where the agency is a nationwide one.
An applicant who wants to see the file needs to know where the file lives.

Then a sentence that feels counterintuitive and is mandatory anyway: a statement
that the consumer reporting agency did not make the decision to take the adverse
action and is unable to provide the consumer the specific reasons why the adverse
action was taken. The screening service compiled data. You decided. The notice says
so in as many words, which keeps applicants from calling the bureau to argue about
a judgment the bureau never made.

The last two items are the applicant’s rights. One is the free copy: notice of the
right to obtain a free copy of the report from that agency, with an indication of
the 60-day window for requesting it. The other is the dispute right: notice of the
right to dispute, with the agency, the accuracy or completeness of anything in the
report. Four items, one page. The template handles all of them.

## The adverse action notice template (copy and paste)

![The free adverse action notice template with denial, tougher-terms, and withdrawn-
offer variants and the mandatory statutory statements in brackets](https://i0.wp.
com/clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-04-template.
jpg?w=1290&ssl=1)

Here is an adverse action notice you can copy and adapt. Bracketed choices cover
the three trigger situations, denial, tougher terms, withdrawn offer, and the four
required elements are baked in so none of them gets dropped in editing.

ADVERSE ACTION NOTICE (FAIR CREDIT REPORTING ACT)

**Date:** [Date]

**To:** [Applicant name], regarding your rental application for [Property address,
including unit].

**1. The action taken.** After reviewing your application, we are [denying the application/
approving the application subject to the following changed terms: (higher security
deposit of $____ / requirement of a qualified co-signer or guarantor / other: ____)/
withdrawing our prior offer].

**2. The consumer report.** This decision was based in whole or in part on information
contained in a consumer report (tenant screening report) provided by:

[Screening company name]
[Street address, city, state, ZIP][Telephone number, including
toll-free number if available][Website, if the agency offers report access online]

**3. Who made the decision.** The consumer reporting agency listed above did not
make this decision and is unable to provide you the specific reasons why the adverse
action was taken. The decision was made by [Landlord / property manager name].

**4. Your rights.** Under the federal Fair Credit Reporting Act, you have the right
to obtain a free copy of your report from the agency listed above if you request
it within 60 days of this notice. You also have the right to dispute directly with
that agency the accuracy or completeness of any information in the report.

**Landlord / Agent:** [Name], [phone and email]

Signature: __________________________   Date: __________

**Delivery record:** Sent on [date] by [method: email / mail / hand delivery], by[
name]. Copy retained with the application file.

Paragraph 3 is the one landlords are tempted to delete because it reads oddly, and
it is a verbatim statutory requirement. Leave it in.

You can copy the notice above and fill the brackets by hand, or answer a short set
of questions and let the required elements land in place. LawDepot’s builder produces
a finished, dated adverse action notice ready to print or email. It is a document
tool, not a law firm, so the screening agency’s contact block still comes from your
report.

[Build Your Notice →](https://clearlegaltips.com/go/lawdepot-realestate)

## How to fill it out, and the reason question

![How to fill out an adverse action notice: copy the screening agency's contact 
block carefully, decide the optional reason line, and send promptly with the decision](
https://i0.wp.com/clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-
05-fill-out.jpg?w=1290&ssl=1)

The screening company’s block deserves a minute of care, since the whole notice 
fails its purpose if the applicant cannot reach the agency. Copy the name, address,
and phone number from the report itself or the service’s compliance page rather 
than from memory; the large screening brands operate under corporate names that 
do not match their logos. If your service provides a pre-filled adverse action insert,
its contact block is usually reliable, and this template’s structure still applies
around it.

Then the question every landlord asks: do I have to give my reasons? Under 1681m(
a) the required statement actually runs the other way, you must say the agency cannot
give specific reasons, and the statute stops short of forcing you to volunteer your
own. Plenty of landlords add a short factual one anyway, “income-to-rent ratio below
our published criterion,” since it cuts confusion and follow-up calls. Anyone doing
that should keep the reason tied to written screening criteria and identical in 
kind between applicants, because a reason invented per-applicant is worse than none.

Timing has the same shape: the statute sets the duty, not a deadline, and the practical
rule is promptly, with the decision itself. The notice sent alongside the rejection
or the revised offer costs one email. The notice reconstructed six months later,
during a dispute, costs considerably more.

## The three trigger moments in a rental workflow

![The three trigger moments for an adverse action notice in a rental workflow: denial,
conditional approval on tougher terms, and the withdrawn offer](https://i0.wp.com/
clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-06-triggers.
jpg?w=1290&ssl=1)

Mapped onto an ordinary application pipeline, tenant screening adverse action fires
in three places. The obvious trigger leads: the [application](https://clearlegaltips.com/rental-application-form-template-2026/)
comes in, the screening report comes back, and the answer is no, the classic rental
application denial. If the report played any part, the notice goes out with the 
no.

Conditional approval is the sneaky one, the yes-but. Yes, but with a co-signer. 
Yes, but with the maximum deposit, or a shorter initial term. Where the but traces
to the report, each of those is an adverse or unfavorable change in terms, squarely
inside 1681a(k), and it takes the same notice. This is the trigger small landlords
miss almost universally, because nothing about a conditional yes feels adverse from
the sending side.

And there is the withdrawn offer, where approval went out, a late or updated report
changed the picture, and the offer got pulled. Same duty, same notice. Here the 
paper trail matters doubly, because a rescinded approval invites harder feelings
and closer scrutiny than a plain rejection ever will.

The notice is the last step of a screening pipeline that works best when every document
matches: application, authorization, criteria, decision. LawDepot’s forms library
covers the rental application and lease side of that pipeline, so the paperwork 
tells one consistent story from first showing to signed lease. You supply the facts;
the forms keep the sequence straight.

[Line Up the Paperwork →](https://clearlegaltips.com/go/lawdepot-realestate)

## Delivery, records, and the applicant’s next move

![Delivering an adverse action notice: written or electronic notice with a delivery
record, and the applicant's 60-day free-copy and dispute path](https://i0.wp.com/
clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-07-delivery.
jpg?w=1290&ssl=1)

Delivery is undemanding by statute, oral, written, or electronic, and demanding 
in practice, because the notice is only worth what you can later prove. Email satisfies
the electronic option and produces its own receipt; a mailed letter does the same
more slowly. Under the E-SIGN Act, an electronic record cannot be denied legal effect
solely because it is electronic, per [15 U.S.C. 7001](https://www.law.cornell.edu/uscode/text/15/7001),
so the emailed notice with a completed delivery record is a perfectly durable artifact.
Keep the copy with the application file, next to the report authorization and the
screening criteria you applied.

For the applicant reading one of these adverse action letters, the CFPB’s [guidance](https://www.consumerfinance.gov/ask-cfpb/what-should-i-do-if-my-rental-application-is-denied-because-of-a-tenant-screening-report-en-2105/)
lays out the path, and it is worth knowing from the landlord’s chair too. The free
copy request goes to the screening agency within the 60-day window. The report gets
read for errors, the wrong person’s eviction, the paid balance shown open, and errors
get disputed with the agency, which must investigate. A corrected report sometimes
reverses the outcome; landlords who leave the door open for that (“we will revisit
the application if the report changes”) lose nothing and occasionally recover a 
good tenant the data had misrepresented.

## Where fair housing meets the FCRA

![Where fair housing meets the FCRA: the notice governs how a report-based decision
is communicated, written screening criteria govern why](https://i0.wp.com/clearlegaltips.
com/wp-content/uploads/2026/07/adverse-action-notice-08-fair-housing.jpg?w=1290&
ssl=1)

Two compliance regimes touch every rejection, and they answer different questions.
The FCRA governs the how: a report was used, so the notice is owed, regardless of
how sound the decision was. Fair housing law governs the why: the decision itself
cannot rest on protected characteristics, whatever the paperwork looks like. A perfect
adverse action notice does not launder a discriminatory decision, and a lawful decision
is still an FCRA violation if the notice never went out.

The practical bridge between the two is written screening criteria: income ratio,
credit threshold, history standard, documentation list, applied identically to every
file. Consistent criteria give your adverse action notices something objective to
sit on, keep the optional reason line factual, and make the difference between “
we decided” and “we applied the standard” visible on paper. Our [screening guide](https://clearlegaltips.com/tenant-screening-report-cost-comparison/)
covers building that rubric; this notice is that rubric’s output on a bad day.

## Mistakes that turn a form letter into liability

![Adverse action notice mistakes: sending nothing, omitting the agency contact block,
blaming the screening bureau, and missing the conditional-approval trigger](https://
i0.wp.com/clearlegaltips.com/wp-content/uploads/2026/07/adverse-action-notice-09-
mistakes.jpg?w=1290&ssl=1)

The dominant mistake is silence: the decision goes out, the notice never does, and
the file shows a report was pulled and used. Nothing about that failure is cured
by time. Next comes the hollow notice, sent without the agency’s contact block or
without the rights paragraph, which delivers the bad news while withholding the 
exact information the statute exists to provide.

Blaming the bureau is a quieter error. “The screening company rejected you” is both
false and the precise opposite of the mandatory statement; the agency compiled, 
you decided, and the notice must say so. And the conditional-approval blind spot
rounds out the list: the higher deposit, the required guarantor, the shortened term,
the moved-up start date, each sent cheerfully with no notice attached, each an adverse
action in the statute’s plain terms.

The fix costs almost nothing. One template, the agency block copied carefully, a
delivery record, a copy in the file. An adverse action notice is a single page that
treats the applicant like someone entitled to see the evidence, which they are, 
and it converts a federal compliance duty into thirty seconds of routine. Send it
every time the report touches the outcome, and this is one law you never think about
again.

A one-page notice sent with every report-based decision is the cheapest federal 
compliance you will ever buy. LawDepot turns your details into a finished adverse
action notice in one sitting and keeps them for the next applicant. For the hard
edges, a discrimination complaint, a disputed report that will not resolve, a rescinded
approval turning hostile, pair the paperwork with a local landlord-tenant attorney.

[Create the Full Notice →](https://clearlegaltips.com/go/lawdepot-realestate)

## Frequently Asked Questions

### What is an adverse action notice for a rental application?

It is the message federal law requires a landlord to send when a consumer report,
in rental practice the tenant screening report, influences a decision against an
applicant. Contents come straight from the Fair Credit Reporting Act: the screening
company’s name, address, and phone number, the statement that the company did not
make the decision and cannot give the specific reasons, the 60-day free-copy right,
and the dispute right. Whoever used the report carries the duty, the landlord, and
one factor among several is enough to trigger it.

### Do landlords really have to send an adverse action notice?

Yes, whenever a screening report played any part in the decision. The duty in 15
U.S.C. 1681m falls on whoever used the report, with no small-landlord exemption 
anywhere in it. Oral, written, or electronic notice all satisfy the statute, which
makes a compliant email enough, though written forms remain the only version you
can later prove you sent. Skipping it does not undo anything, since the file still
shows a report was pulled and a decision followed. The one-page letter sent with
the decision is the entire cost of compliance.

### Is requiring a co-signer or a bigger deposit an adverse action?

Under the FCRA’s definition, yes, when the screening report drove the requirement.
The statute reaches an increase in any charge and any adverse or unfavorable change
in terms, not only outright denials, and the FTC’s landlord guidance names these
exact examples: requiring a co-signer on the lease, and requiring a deposit that
would not be required for another applicant. The conditional yes feels like good
news from the sending side, which is why this trigger gets missed. Send the notice
along with the revised offer, and check your state’s deposit cap before raising 
the deposit at all.

### Does the landlord have to say why the application was denied?

Oddly enough, the one statement 1681m(a) makes mandatory points the other way: the
notice must say the screening agency did not make the decision and cannot provide
the specific reasons. Nothing in the statute forces the landlord to volunteer reasons
of their own. Many landlords add a short factual one anyway, tied to written screening
criteria, because it cuts down confusion and phone calls. If you do, keep it consistent
across applicants and grounded in the criteria you actually applied; an improvised
reason is worse than none, and a discriminatory one is a different law’s problem
entirely.

### What can an applicant do after receiving an adverse action notice?

Use the rights printed on it. Request the free copy of the report from the screening
agency named in the notice, within the 60-day window. Read it for errors, the wrong
person’s record, a paid debt shown open, an address that was never yours, an eviction
that is not yours, and dispute inaccuracies with the agency, which must investigate.
The CFPB’s guidance walks through the same steps from the consumer side. A corrected
report sometimes changes the outcome, and it always cleans the file for the next
application, which is worth the effort even when this rental is gone.

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### Related Articles

 * [Tenant Screening Report Cost Comparison](https://clearlegaltips.com/tenant-screening-report-cost-comparison/)
 * [Rental Application Form Template](https://clearlegaltips.com/rental-application-form-template-2026/)
 * [Co-Signer Agreement for a Lease](https://clearlegaltips.com/lease-co-signer-agreement/)

### Sources & References

 * [law.cornell.edu](https://www.law.cornell.edu/uscode/text/15/1681m)
 * [law.cornell.edu](https://www.law.cornell.edu/uscode/text/15/1681a)
 * [law.cornell.edu](https://www.law.cornell.edu/uscode/text/15/1681b)
 * [law.cornell.edu](https://www.law.cornell.edu/uscode/text/15/7001)
 * [consumerfinance.gov](https://www.consumerfinance.gov/ask-cfpb/what-should-i-do-if-my-rental-application-is-denied-because-of-a-tenant-screening-report-en-2105/)
 * [ftc.gov](https://www.ftc.gov/business-guidance/resources/using-consumer-reports-what-landlords-need-know)

_Fact-checked: August 2026_

**Legal Disclaimer:** This article is general information, not legal advice. ClearLegalTips
is not a law firm and does not provide legal representation. Laws vary by state 
and change over time. For guidance on your specific situation, consult a licensed
attorney in your jurisdiction.

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ClearLegalTips is an independent publisher of plain-English legal guides, free document
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