REAL ESTATE RENTAL FORM
Application and Verification

DENIAL BASED ON CREDIT REPORT               

FROM:                                                                                                       

Date:    _________________________

Dear:                                                                                                          

This notice is to inform you that your request for tenancy has been denied because of the item checked below:

__ Insufficient information on the credit report provided by the following:

_______________________________________________________________

The above includes the name and telephone number of a consumer credit reporting agency providing the credit report; including toll-free if this is a national credit reporting agency.

__ Negative information on the credit report provided by the following:

_______________________________________________________________

The above includes the name and telephone number of a consumer credit reporting agency providing the credit report; including toll-free if this is a national credit reporting agency.

The consumer credit reporting agency above did not make the decision not to rent to you and cannot explain why your tenancy was denied. The agency only provided information about your credit history.

This notice is provided to meet the requirements of the Federal Fair Credit Reporting Act. You have the right under this Act to obtain a free copy of your credit report from the consumer credit reporting agency named above, if you request it within 60 days of this notice. You also have the right to dispute the accuracy or completeness of your credit report and add your own consumer statement (up to 100 words) to the report.

For more information, contact the above-named consumer credit reporting agency.

Owner/Manager ________________________________ Date ______________