Dealership Adverse Action Notice Issuance Log

Tracks issuance of adverse action notices for declined or conditionally approved credit applicants to support ECOA and FCRA compliance.

Applicant Decision Record

• Application Reference ID
  Enter the internal application or deal reference number. Do not enter SSN or full account numbers.
• Credit Decision Date
  Date the decline or conditional approval decision was made.
• Decision Outcome
  Select the outcome that triggered the adverse action notice.
• Decision Made By
  Name or role of the employee who made the credit decision.

Notice Issuance Details

• Notice Issue Date
  Date the adverse action notice was sent or handed to the applicant.
• Delivery Method
  Select how the notice was delivered.
• If Other, specify delivery method
• Notice Sent By
  Employee or system responsible for issuing the notice.
• Delivery Confirmation Available
  Check if you have proof of mailing, email delivery, portal receipt, or handoff acknowledgment.

Compliance Reason and Content Check

• Reason Codes Included
  Select all reason codes included in the notice.
• If Other, describe the reason
• Credit Reporting Agency Disclosure Included
  Confirm the notice included the required credit reporting agency information, if applicable.
• Notice Template Version
  Record the version or form number of the notice used for the audit trail.

Audit Trail and Follow-Up

• Was there any exception or delay in issuing the notice?
  Select Yes if the notice was delayed, reissued, or required correction.
• Exception Details
  Describe the issue, corrective action taken, and whether the applicant was re-notified.
• Record Retention Location
  Enter the system, folder, or log location where supporting documentation is stored.
• Reviewed By
  Optional compliance reviewer or manager name for internal audit trail.