Creditor’s name
Creditor’s address
If
your application for business credit is denied, you have the right
to a written statement of the specific reasons for the denial. To
obtain the statement, please contact [name, address, and telephone
number of the person or office from which the statement of reasons
can be obtained] within 60 days from the date you are notified of
our decision. We will send you a written statement of reasons for
the denial within 30 days of receiving your request for the statement.
NOTICE: The federal
Equal Credit Opportunity Act prohibits creditors from discriminating
against credit applicants on the basis of race, color, religion, national
origin, sex, marital status, age (provided the applicant has the capacity
to enter into a binding contract); because all or part of the applicant’s
income derives from any public assistance program; or because the
applicant has in good faith exercised any right under the Consumer
Credit Protection Act. The federal agency that administers compliance
with this law concerning this creditor is [name and address as specified
by the appropriate agency listed in appendix A].
