Membership Adverse Action Notice Financial Institution: IBM Southeast Employees' Federal Credit Union P. O. Box 5090, Boca Raton, FL 33431-0890 800.873.5100 - 561.982.4700 serviceplus@ibmsecu.org Member: Date: SSN/TIN: Membership: "We" means IBM Southeast EFCU. "You" means potential or current Member. Description of Account, Transaction or Request: [ ] New Membership Savings. [ ] New Checking account. [ ] New VISA Check Card. [ ] Other: Description of Action Taken: This notice is to inform you that: [ ] We are unable to approve your request. [ ] We are unable to approve your request in its entirety. We have approved your request for a: [ ] Membership Savings. [ ] Checking account. [ ] VISA Check Card. [ ] Other: We were unable to approve your request for a: [ ] Membership Savings. [ ] Checking account. [ ] VISA Check Card. [ ] Other: Principal Reasons for Action Taken: Other Principal Reasons may have influenced our decision. Contact the Credit Union for further details. [ ] 1. A negative ChexSystems record reported within the past twelve (12) months, that contained a notice of account abuse, fraud or unpaid monies owed to a financial institution. [ ] 2. Derogatory activity on existing or previous IBM Southeast EFCU accounts within the past twelve (12) months. ( ) Check and/or ACH Non-Sufficient Fund (NSF), negative balance, overdrawn and/or delinquent accounts. ( ) Accounts that resulted in a financial loss to the Credit Union, including negative share and loan charge offs. [ ] 3. Derogatory credit record reported within the past seven (7) years to a credit reporting agency. Please see the reverse side of this notice for more information regarding your credit bureau record. [ ] 4. Unable to verify: ( ) Social Security Number (SSN) or other Tax Identification Number (TIN) - Provide a legible photocopy of your SSA Social Security Card, or IRS Employment Authorization Document, and a letter of verification from the Social Security Administration (SSA) or the Internal Revenue Service (IRS). ( ) Driver's License or other identification - Provide a legible photocopy of your driver's license or other unexpired government issued photo identification. ( ) Residential Address - Provide a legible photocopy of your utility bill or other document to be used to verify your residential address. [ ] 5. Other: [ ] If checked, the number of inquiries was also a principal reason adversely affecting your request for Membership. Disclosure of Use of Information Obtained from an Outside Source Our decision was based in whole or in part on information obtained in a report from the consumer reporting agency or agencies listed on the following page. You have a right under the Fair Credit Reporting Act (FCRA) to know the information contained in your file at the consumer reporting agency. The reporting agency played no part in our decision and is unable to supply specific reasons why we have denied your request. You also have a right to a free copy of your report from the reporting agency, if you request it no later than sixty (60) days after you receive this notice. In addition, if you find that any information contained in the report you receive is inaccurate or incomplete, you have the right to dispute the matter with the reporting agency. Adverse Action - Notice of Action Taken VMP Bankers Systems Custom MDF.EFLDNFCR Wolters Kluwer Financial Services 1997, 2011 - IBM Southeast EFCU 11/2012 DN-FCRA-D 7/15/2011 Page 1 of 2 | Notice of Action Taken [continued] Name Mailing Address Telephone Toll-Free Web Address ChexSystems, Inc. Attn: Consumer Relations 7805 Hudson Road, Suite 100 Woodbury, MN 55125 800 - 428 - 9623 www.consumerdebit.com Equifax, Inc. P. O. Box 740241, Atlanta, GA 30374 800 - 685 - 1111 www.equifax.com Experian Information Solutions, Inc. P. O. Box 2002 Allen, TX 75013 888 - 397 - 3742 www.experian.com Social Security Administration Office of Public Inquiries, Windsor Park Building, 6401 Security Blvd. Baltimore, MD 21235 800 - 772 - 1213 www.ssa.gov TransUnion, LLC P. O. Box 1000, Chester, PA 19022-2000 800 - 888 - 4213 www.transunion.com For more information: For more information about credit reports and your rights under federal law, visit the Consumer Financial Protection Bureau (CFPB) web site at www.consumerfinance.gov/learnmore. To obtain a free copy of your credit report, contact the Annual Credit Report Request Service. Annual Credit Report Request Service P. O. Box 105283, Atlanta, GA 30348-5283 877 - 322 - 8228 www.annualcreditreport.com We also obtained your credit score from , a consumer reporting agency, and used it in making our decision. Your credit score is a number that reflects the information in your consumer report. Your credit score can change, depending on how the information in your consumer report changes. Your credit score: Date: Scores range from a low of 350 to a high of 900. Key factors that most adversely affected your credit score: Other Key Factors may have influenced our decision. Contact the Credit Union for further details. [ ] 1. Ratio of balance to limit on bank revolving or other revolving accounts is too high. [ ] 2. Length of time that accounts have been established with the Credit Union is too short. [ ] 3. Proportion of loan balances to loan amounts is too high. [ ] 4. Derogatory public record or collection filed. [ ] 5. Excessive obligations. [ ] 6. Excessive unsecured debt. [ ] 7. Credit bureau trade line history insufficient. [ ] 8. Income insufficient. [ ] 9. Tax lien, garnishment, judgment and/or levy. [ ] 10. Other: [ ] If checked, the number of inquiries was also a key factor adversely affecting your credit score. If you have any questions regarding your credit score, you should contact at their address and telephone number above. Our decision was based in whole or in part on information obtained from an affiliate or from an outside source other than a consumer reporting agency. Under the Fair Credit Reporting Act (FCRA), you have the right to make a written request, no later than sixty (60) days after you receive this notice, for disclosure of the nature of this information. If you have applied for credit and your loan was not approved as requested, you will receive a separate adverse action notice. If you applied for a loan at the same time you applied for Membership, you will receive a separate notice regarding your loan request. If you applied with a co-applicant who adversely affected your Membership approval, they will receive their own separate notice. Adverse Action - Notice of Action Taken VMP Bankers Systems Custom MDF.EFLDNFCR Wolters Kluwer Financial Services 1997, 2011 - IBM Southeast EFCU 11/2012 DN-FCRA-D 7/15/2011 Page 2 of 2 |