To (Applicant's Names): ___________________________________________________

Re (Address): ____________________________________________________________

This notice is sent or served upon you this _______________ day of ________________________.

We regret to inform you that your application to rent the above property is denied in part or entirely because of: ( ) Credit ( ) Other information contained in a consumer credit report.

Within 60 days from the date hereof, you may contact the below indicated reporting firm(s) for a free written, telephonic, electronic, or in-person disclosure of your information in accordance with law (a fee may be required). After disclosure, you will have the right to dispute the accuracy or completeness of the disclosed information. If a dispute does not result in the deletion or correction on your credit report, you have the right to put a consumer statement on your file of up to 100 words explaining any inaccuracy or your position of the disputed information.


( ) Experian Consumer Assistance
P.O. Box 2104, Allen, TX 75002
(888) 397-3742

( ) Other: _________________________________________________
Must provide the name, address and telephone number of Agency

Notice: This denial decision was not made by the reporting agency and the bureau cannot provide the specific reason why that decision was made.



This form is to be completed and sent or served upon your applicant in the event you deny an application for tenancy or you increase the security deposit for an accepted tenant with or without the use of a consumer report.

1) Enter the name(s) of your applicant(s) at the top.
2) Enter the address of the property for which the application was made.
3) Enter the date of the denial or additional deposit required. Send or serve this notice on the same date per #7 below.
4) Check the reason(s) Credit or Other or Both for the denial or additional deposit required.
5) Check which bureau(s) supplied the reports that caused you to deny or require additional deposit from your resident.
6) Photocopy this completed form for your records. (All records regarding your investigation, which lead to denial or additional deposit should be saved for at least three years.
7) Serve this notice on your applicant(s) either personally or via ordinary first class mail, postage prepaid.

(Note: To request an instant, low-cost online tenant credit report, click here.)