# Pre-Adverse Action Notice Template for NEMT Driver Background Checks

Canonical URL: https://nemtguide.com/templates/pre-adverse-action-notice/ · Updated 2026-10-02

A pre-adverse action notice is the letter you send before you turn down a driver because of a background check or driving record from a screening company. Federal law requires a copy of the report and the CFPB summary of rights with it. Wait a reasonable time, then send a separate adverse action notice. California, Illinois, and New York City require at least 5 business days.

- Send the first letter, with a full copy of the report and the CFPB summary of rights, before you decide anything.
- Federal law sets no number of days. FTC staff say some reasonable time must pass and the two notices cannot be one document.
- California, Illinois, and New York City add a review of the convictions against the job, a notice naming them, and at least 5 business days to respond.
- Washington makes employers hold the job open 2 business days: those with 15 or more employees since July 1, 2026, and all employers from January 1, 2027.
- A broker rule that bars the driver does not excuse the federal letters. Send them anyway and name the rule.

When a screening company's report is part of the reason you turn down a driver, federal law makes the "no" a two-letter process. The first letter warns the person and hands them the report. The second makes it final, and only after a fair chance to answer. This page gives you both letters, an add-on for places with fair chance laws, and a record of dates that shows you waited.

## How to use this template

1. **Check that the letters apply.** Use them when a report from a screening company plays any part in the decision: a criminal check, a [driving record](https://nemtguide.com/glossary/motor-vehicle-record/), or a work history check. [NEMT driver background checks](https://nemtguide.com/guides/nemt-driver-background-check/) covers the consent you need before the check and where these letters fit in the process.
2. **Confirm the record before you write.** Make sure the report is about the right person. Then compare the offense, its date, and how the case ended with each broker and state rule you work under. [Can a felon be a NEMT driver](https://nemtguide.com/guides/nemt-driver-disqualifying-offenses/) lists those rules.
3. **Fill in Part 1 as you go.** It is your proof of what you sent and when.
4. **Send Part 2 with two enclosures:** a complete copy of the report and the CFPB's "A Summary of Your Rights Under the Fair Credit Reporting Act." Use the March 2023 version from the CFPB. A Spanish version is on the CFPB's model forms page.
5. **Add Part 3 if a fair chance law covers the job,** such as in California, Illinois, New York City, or Washington. Fill it in before you mail Part 2, because it goes in the same envelope.
6. **Wait out the deadline.** Make no decision until the date in Part 2 has passed, plus any extension. Read whatever the person sends and note it in Part 1.
7. **Decide, then send Part 4** if the answer is still no. If you change your mind, tell the person and keep the record.
8. **File it, then destroy the report properly.** Keep the letters, the report, and any response with the hiring record. Employers covered by federal job discrimination rules keep hiring records at least one year (29 CFR 1602.14). When you no longer need the report, shred it or wipe the file so it cannot be read or rebuilt (16 CFR 682.3).

For the rest of the hiring steps, from the job ad to the road test, see [how to hire NEMT drivers](https://nemtguide.com/guides/hire-nemt-drivers/).

## The template

### Part 1: Decision record

| Field | Write it here |
|---|---|
| Applicant or driver name, and the job (driver, attendant, other) | |
| City and state where the job is, and your number of employees | |
| Date of the conditional job offer, if one was made | |
| Date the person signed the background check permission | |
| Screening company name, mailing address, phone, and toll-free number | |
| Report number and the date you received it | |
| What in the report may lead to a no (offense or violation, date, court) | |
| The rule it may break (broker contract section, state rule, or your written policy) | |
| Approval asked for, if the rule allows one (from whom, date, answer) | |
| Pre-adverse action notice sent (date, method, tracking number or receipt) | |
| Date it was received, or the date it counts as received | |
| Response deadline given | |
| Response received (date, and what the person sent) | |
| Final decision, its date, and who made it | |
| Adverse action notice sent (date and method) | |
| Date the report was destroyed, and how | |

### Part 2: Pre-adverse action notice

[Your company letterhead]

Date: ______________

To: ______________________________ (name, and mailing or email address)

Re: Your background report and your [application / job] as a [driver / attendant / ______________]

Dear ______________:

With your written permission dated ______________, we received a background report about you from ______________________________ (the screening company). Information in that report may lead us to [withdraw our job offer / not hire you / take you off driving / end your employment]. We have not made a final decision.

The part of the report we are reviewing: ______________________________

[If a contract rule applies:] Our agreement with ______________ (broker or health plan), section ______, does not allow drivers with ______________________________ to carry its riders.

We have enclosed:

- A complete copy of the report
- "A Summary of Your Rights Under the Fair Credit Reporting Act"
- [Our written review of the convictions, if your state or city requires it]

If anything in the report is wrong, out of date, or about someone else, or if there is anything you want us to consider, contact ______________ at ______________ (phone or email) by ______________ (date). You may also dispute errors directly with the screening company at ______________ (phone).

We will not make a final decision before ______________ (date).

Sincerely,

______________________________ (name, title, and phone)

### Part 3: Fair chance add-on (California, Illinois, New York City, Washington)

Convictions that are the reason for this early decision: ______________________________

| What we weighed | What we found | Which law asks for it |
|---|---|---|
| The offense: what happened and how serious it was | | California, Illinois, New York City |
| Time since the offense, and since the sentence ended | | California, Illinois, New York City |
| The duties of this job (driving riders alone, helping them in and out, handling their health information) | | California, New York City, and Illinois as part of its job relationship test |
| Your age at the time of the offense | | Illinois, New York City |
| How many convictions the record shows | | Illinois |
| The facts and circumstances of the offense | | Illinois |
| Evidence of rehabilitation you have already given us | | Illinois, New York City |
| A certificate of relief from disabilities or of good conduct | | New York City |
| Why we believe the record relates to this job or creates an unreasonable risk | | Illinois and New York City require it; California makes it optional; Washington asks for a legitimate business reason |

**Your right to respond.** Before we decide, you may send us evidence that the record is wrong, evidence of rehabilitation or of circumstances we should know about, or both. Examples include proof that a case was dismissed or sealed, completion of probation or parole, school, job training, or treatment programs, your work history, and letters from employers, counselors, or probation officers.

**Your deadline:** ______________ (at least 5 business days after you receive this in California, Illinois, and New York City. In California, if you tell us in writing before then that you dispute the report and are getting proof, you get 5 more business days.)

**We are holding this job open for you until:** ______________ (at least 5 business days in New York City and at least 2 business days in Washington)

### Part 4: Adverse action notice

[Your company letterhead]

Date: ______________

To: ______________________________ (name, and mailing or email address)

Re: Our decision about your [application / job]

Dear ______________:

On ______________ we sent you a copy of your background report and a summary of your rights, and gave you until ______________ to respond. [We received your response on ______________ and considered it. / We did not receive a response.]

We have decided to [withdraw our job offer / not hire you / take you off driving / end your employment]. This decision was based in whole or in part on information in a consumer report from:

Screening company: ______________________________

Address: ______________________________

Phone: ______________ Toll-free phone, if it has one: ______________

The screening company did not make this decision and cannot tell you the specific reasons for it.

You have the right to a free copy of your report from the screening company if you ask for it within 60 days. You also have the right to dispute with the screening company anything in the report you believe is inaccurate or incomplete.

[California:] To ask us to reconsider this decision: ______________________________. You also have the right to file a complaint with the California Civil Rights Department.

[Illinois:] The convictions this decision rests on, and our reasons: ______________________________. To challenge it or ask us to reconsider: ______________________________. You have the right to file a charge with the Illinois Department of Human Rights.

[Washington:] Our reasons, and how we weighed the conviction against the job and your rehabilitation, good conduct, work experience, education, and training: ______________________________

Sincerely,

______________________________ (name, title, and phone)

## What federal law requires in each letter

The Fair Credit Reporting Act sets the minimum everywhere, for every employer size, whenever a report from a screening company is part of the decision.

**The first letter** ([15 U.S.C. 1681b(b)(3)](https://www.law.cornell.edu/uscode/text/15/1681b)). Before you act on the report, give the person a copy of it and a written summary of their rights in the form the CFPB prescribes. The CFPB's model summary was last updated in a rule effective April 19, 2023, with compliance required from March 20, 2024. Your summary must be substantially similar to the model, and an accurate translation in a language the person uses also complies (Appendix K to 12 CFR part 1022). The screening company must give you the summary with the report or before it, so ask for it if it is missing.

**The wait.** Federal law sets no number of days. FTC staff wrote in their July 2011 staff report that some reasonable period must pass and that its length depends on the circumstances. If the person disputes the report with the screening company, the company generally has 30 days to reinvestigate (15 U.S.C. 1681i), so a dispute in progress is a reason to wait longer.

**Two letters, never one.** The same FTC staff report says the first notice comes before the decision and the final notice after it, so they may not be in the same document. The final letter can simply note that the person already received the report and the summary.

**The final letter** ([15 U.S.C. 1681m(a)](https://www.law.cornell.edu/uscode/text/15/1681m)). It may be oral, written, or electronic. It must give the screening company's name, address, and phone number, plus a toll-free number if the company keeps files nationwide. It must say the company did not make the decision and cannot give the specific reasons. It must tell the person they may get a free copy of the report within 60 days and may dispute anything in it. If a credit score was part of the decision, the notice must disclose the score too.

**Current drivers count.** Adverse action includes any employment decision that hurts a current employee as well as an applicant ([15 U.S.C. 1681a(k)](https://www.law.cornell.edu/uscode/text/15/1681a)), and FTC staff list discipline and termination as examples. When a yearly recheck turns something up, use the same two letters before you take a driver off trips.

**The narrow trucking exception.** For jobs whose qualifications and hours the U.S. Department of Transportation sets, or that a state transportation agency regulates for safety, the law allows a single notice within 3 business days after you turn down an applicant. It applies only when, up to the time you ordered the report, the applicant dealt with you only by mail, phone, or computer. An applicant who came in for an interview or road test before then does not fit it. Send both letters.

## Fair chance laws that add steps

Several states and cities add a review of the convictions against the job, more detail in the first letter, and a longer wait. Five examples, as of October 2026:

| Law | Who it covers | Time to respond |
|---|---|---|
| California, Gov. Code 12952 | Employers with 5 or more employees | At least 5 business days from receipt, plus 5 more if the person disputes the report and is getting proof |
| Illinois, 775 ILCS 5/2-103.1 | Employers with 1 or more employees in Illinois in 20 or more weeks of this year or last | At least 5 business days |
| New York City, Fair Chance Act | Employers with 4 or more employees | At least 5 business days from receipt, with the job held open |
| Washington, RCW 49.94.010 | Employers with 15 or more employees since July 1, 2026, and all employers from January 1, 2027 | The job held open at least 2 business days |
| New York State, Correction Law Article 23-A | Private employers with 10 or more employees | No set wait. Written reasons within 30 days if the person asks |

What each first letter adds:

- **California.** The convictions behind the decision, a copy of the report, and the person's right to respond with evidence of errors, rehabilitation, or mitigating circumstances, with the deadline. Your reasons are optional. A mailed letter without tracking counts as received 5 calendar days after mailing to a California address, and an email 2 business days after it is sent (2 CCR 11017.1). The final letter gives any reconsideration procedure you have and the right to complain to the Civil Rights Department.
- **Illinois.** The convictions and your reasoning, which is required here, plus the report and the right to respond. The final letter repeats the convictions and reasons, gives any reconsideration procedure, and names the right to file a charge with the Department of Human Rights.
- **New York City.** A copy of every piece of information you relied on, with the date and time you got it, and your written Fair Chance Analysis. The city's Commission on Human Rights publishes a Fair Chance Notice form you may adapt.
- **Washington.** The record you are relying on. If you still say no after the hold, you owe a written decision that explains your reasoning and how you weighed each factor. The law does not apply to jobs with unsupervised access to children or to vulnerable adults as Washington law defines them. A NEMT driving job may fit that exception; the [Washington state guide](https://nemtguide.com/states/washington/) lists the checks brokers there run on drivers. Ask an employment lawyer before you rely on it.

Other states and cities have their own rules, and some apply to fewer jobs. The fair chance section of [can a felon be a NEMT driver](https://nemtguide.com/guides/nemt-driver-disqualifying-offenses/) covers what these laws require before you say no.

## When a broker rule already bars the driver

Sometimes the reason is a contract rule rather than your own judgment. MTM Health's standard agreement (January 1, 2023 version, posted by Pennsylvania) bars drivers and attendants with any prior conviction for a sexual crime or a crime of violence, and allows a felony from the last 7 years only with its client's approval. That rule tells you who cannot carry MTM's riders. It does not replace the letters.

- **The federal letters still apply.** The Fair Credit Reporting Act requires both notices before any adverse action based in whole or in part on a report. It has no exception for decisions a contract requires.
- **California's exception needs a law, not a contract.** The Fair Chance Act steps drop away only where a state, federal, or local law requires the employer itself to run criminal checks or to restrict hiring. The regulation adds that a law requiring someone else, such as a licensing board, to run the check does not exempt the employer (2 CCR 11017.1). A broker agreement is not on the list.
- **New York City reads exemptions narrowly.** Its Commission on Human Rights lets an employer skip the Fair Chance Analysis for a mandatory bar imposed by law, not for a bar that leaves the employer a choice, and the employer must prove the exemption applies. A law that only requires a background check does not excuse the analysis. Even under a mandatory bar, the Commission calls giving the person a copy of what you relied on a best practice, and you must consider evidence that the conviction was recorded in error. Concerns about any other part of the record still get the full process.
- **Illinois applies "unless otherwise authorized by law."** Plan on the full Illinois process unless a law authorizes a different one.

So when a broker rule is the reason, name it in Part 2, ask for any approval the rule allows before you decide, and send the letters on the same schedule as any other decision. A person with an old record may still qualify for a different contract with a different rule, so compare every program before you write the final letter. Keep a copy of both letters in the [driver application file](https://nemtguide.com/templates/nemt-driver-application/), and an employment lawyer in your state can confirm whether any exception fits your jobs.

## Frequently asked questions

### How long do I have to wait between the pre-adverse and adverse action notice?

Federal law sets no number of days. FTC staff say some reasonable period must pass and that the right length depends on the circumstances. State and city laws set floors: at least 5 business days in California, Illinois, and New York City, and a 2 business day hold in Washington. In California the person gets 5 more business days if they dispute the report and are getting proof.

### Can I put both notices in one letter?

No. The first notice must reach the person before you decide and the second comes after, so FTC staff say the two cannot be the same document. The final letter can say the person already received the report and the summary of rights, so you do not have to send them twice.

### Do I still send the letters if the broker will not approve the driver?

Yes, whenever the decision rests even partly on a screening company's report. The federal rule has no exception for decisions a contract requires. Name the broker rule in the letter, and still give the person time to show that the record is about someone else, was dismissed, or is out of date.

### Do these letters apply to current drivers after a recheck?

Yes. Under the Fair Credit Reporting Act, adverse action includes any employment decision that hurts a current employee, such as taking a driver off trips or ending the job. MTM Health's standard contract (January 1, 2023 version) asks for a new criminal check every year, so expect to use these letters for drivers already on staff.

### Do I need the letters for a 1099 driver?

Send them. FTC staff read "employment purposes" broadly, and their July 2011 report says it covers drivers who own and run their own trucks for a trucking company. The same reasoning fits a contract driver you check before giving NEMT trips. MTM Health's standard contract also applies its driver rules to anyone you directly retain or employ.

### Can I send the letters by email?

The final notice may be oral, written, or electronic under 15 U.S.C. 1681m, but a written copy leaves proof. The first notice includes a written summary of rights, so send it in a form you can prove you delivered. In California an emailed notice counts as received 2 business days after it is sent, and an untracked letter 5 calendar days after mailing to a California address.

## Official resources

- [CFPB: A Summary of Your Rights Under the Fair Credit Reporting Act (send it with the first letter)](https://files.consumerfinance.gov/f/documents/bcfp_consumer-rights-summary_2018-09.pdf)
- [CFPB: Model forms page, with the Spanish summary of rights](https://www.consumerfinance.gov/compliance/compliance-resources/other-applicable-requirements/fair-credit-reporting-act/model-forms-and-disclosures/)
- [FTC: Using Consumer Reports, What Employers Need to Know](https://www.ftc.gov/business-guidance/resources/using-consumer-reports-what-employers-need-know)
- [California Civil Rights Department: Fair Chance Act sample forms packet](https://calcivilrights.ca.gov/wp-content/uploads/sites/32/2023/03/Fair-Chance-Act-Sample-Forms-Packet.pdf)
- [New York City Commission on Human Rights: Fair Chance Notice form](https://www.nyc.gov/assets/cchr/downloads/pdf/FairChance_Form23-A_distributed.pdf)
- [Washington State Legislature: RCW 49.94.010, Fair Chance Act](https://app.leg.wa.gov/RCW/default.aspx?cite=49.94.010)