Simply replace the unfilled areas such as "__" and "_[date]_" with your information.
We regret to inform you that we will no longer be able to offer you a position within this firm. As you know, we perform a thorough background check, provided by _[Company]_, on all candidates before they are hired. It has come to our attention that the information you provided in your application was either incorrect or incomplete.
We have a very strict policy regarding full disclosure on new-hire applications. This policy was provided to you during the application process. Therefore, we must rescind your previous offer of employment. If you have any further questions you may contact _[Name]_ at _[Phone number]_ between the hours of _[hour]_ and _[hour]_.