FCU - Fair Credit Reporting

Bur. of Consumer Financial Protection

Pt. 1022, App. H

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APPENDIX H TO PART 1022—MODEL
FORMS FOR RISK-BASED PRICING AND
CREDIT SCORE DISCLOSURE EXCEPTION NOTICES
1. This appendix contains four model forms
for risk-based pricing notices and three
model forms for use in connection with the
credit score disclosure exceptions. Each of
the model forms is designated for use in a
particular set of circumstances as indicated
by the title of that model form.
2. Model form H–1 is for use in complying
with the general risk-based pricing notice requirements in Sec. 1022.72 if a credit score is
not used in setting the material terms of
credit. Model form H–2 is for risk-based pricing notices given in connection with account
review if a credit score is not used in increasing the annual percentage rate. Model form
H–3 is for use in connection with the credit
score disclosure exception for loans secured
by residential real property. Model form H–4
is for use in connection with the credit score
disclosure exception for loans that are not
secured by residential real property. Model
form H–5 is for use in connection with the
credit score disclosure exception when no
credit score is available for a consumer.
Model form H–6 is for use in complying with
the general risk-based pricing notice requirements in Sec. 1022.72 if a credit score is used
in setting the material terms of credit.
Model form H–7 is for risk-based pricing notices given in connection with account review if a credit score is used in increasing
the annual percentage rate. All forms contained in this appendix are models; their use
is optional.
3. A person may change the forms by rearranging the format or by making technical
modifications to the language of the forms,
in each case without modifying the substance of the disclosures. Any such rearrangement or modification of the language

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of the model forms may not be so extensive
as to materially affect the substance, clarity, comprehensibility, or meaningful sequence of the forms. Persons making revisions with that effect will lose the benefit of
the safe harbor for appropriate use of appendix H model forms. A person is not required
to conduct consumer testing when rearranging the format of the model forms.
a. Acceptable changes include, for example:
i. Corrections or updates to telephone
numbers, mailing addresses, or Web site addresses that may change over time.
ii. The addition of graphics or icons, such
as the person’s corporate logo.
iii. Alteration of the shading or color contained in the model forms.
iv. Use of a different form of graphical
presentation to depict the distribution of
credit scores.
v. Substitution of the words ‘‘credit’’ and
‘‘creditor’’ or ‘‘finance’’ and ‘‘finance company’’ for the terms ‘‘loan’’ and ‘‘lender.’’
vi. Including pre-printed lists of the
sources of consumer reports or consumer reporting agencies in a ‘‘check-the-box’’ format.
vii. Including the name of the consumer,
transaction identification numbers, a date,
and other information that will assist in
identifying the transaction to which the
form pertains.
viii. Including the name of an agent, such
as an auto dealer or other party, when providing the ‘‘Name of the Entity Providing
the Notice.’’
ix. Until January 1, 2013, substituting ‘‘For
more information about credit reports and
your rights under Federal law, visit the Federal
Reserve
Board’s
Web
site
at
www.federalreserve.gov, or the Federal Trade
Commission’s Web site at www.ftc.gov.’’ for
‘‘For more information about credit reports
and your rights under Federal law, visit the
Consumer Financial Protection Bureau’s

Web
site
at
www.consumerfinance.gov/
learnmore.’’
b. Unacceptable changes include, for example:
i. Providing model forms on register receipts or interspersed with other disclosures.
ii. Eliminating empty lines and extra
spaces between sentences within the same
section.
4. If a person uses an appropriate appendix
H model form, or modifies a form in accordance with the above instructions, that person shall be deemed to be acting in compliance with the provisions of § 1022.73 or
§ 1022.74, as applicable, of this part. It is intended that appropriate use of Model Form
H–3 also will comply with the disclosure that
may be required under section 609(g) of the
FCRA. Optional language in model forms H–
6 and H–7 may be used to direct the consumer to the entity (which may be a consumer reporting agency or the creditor
itself, for a proprietary score that meets the
definition of a credit score) that provided the
credit score for any questions about the
credit score, along with the entity’s contact
information. Creditors may use or not use
the additional language without losing the
safe harbor, since the language is optional.
H–1 Model form for risk-based pricing notice.
H–2 Model form for account review riskbased pricing notice.
H–3 Model form for credit score disclosure
exception for credit secured by one to four
units of residential real property.
H–4 Model form for credit score disclosure
exception for loans not secured by residential real property.
H–5 Model form for credit score disclosure
exception for loans where credit score is not
available.
H–6 Model form for risk-based pricing notice with credit score information.
H–7 Model form for account review riskbased pricing notice with credit score information.

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Bur. of Consumer Financial Protection