Form 6422/08 Consumer Satisfaction Questionnaire

OMB NUMBER: 3064-0127 EXPIRATION DATE: 5/31/2007
Federal Deposit Insurance Corporation Consumer satisfaction questionnaire
Instructions: Forward the completed questionnaire to the sponsoring Division/Office.
How did you learn of the Federal Deposit Insurance Corporation’s (FDIC’s) Consumer Complaint Program? (Check all that apply and circle the ONE that prompted you to contact us.)
TV/radio				Bank
Magazines/newspapers				Referral from another agency/consumer protection agency
Brochure/consumer resource handbook				Internet/computer
Friend/relative				Other
2. Before you contacted the FDIC with your complaint, what else did you do to resolve your problem? (Check all that apply)
Took no other action				Contacted the Better Business Bureau
Complained to friends/family				Contacted a local or state consumer agency
Complained to your bank’s branch or office				Contacted a lawyer
Complained to your bank’s headquarters				Contacted another federal agency
Complained to a radio/TV/newspaper reporter				Other (please specify)
				     
3. How much money was involved in your complaint?				     
4. How satisfied are you with the following aspects of the FDIC’s Consumer Complaint Program? (Rate the level of your satisfaction below)
5=Very Satisfied	4=Satisfied	3=Neither Satisfied nor Dissatisfied			2=Dissatisfied		1=Very dissatisfied		0=Not applicable
								Rating Score
The ease of contacting the FDIC’s Consumer Complaint Program.								     
The courtesy of the FDIC staff in their communication via letters.								     
The amount of time it took to resolve your complaint.      
The thoroughness of the FDIC’s investigation of your complaint.								     
The outcome met all the stated objectives.								     
5. On a scale of 1 to 5, how would you rate your situation and the FDIC’s response using the following rating scale?
5=Strongly Agree	4=Agree		3=Neither Agree nor Disagree			2=Disagree		1=Strongly Disagree
								Rating Score
The matter I complained about could or did cause severe financial hardship for me.
The FDIC’s response was completely clear.
The FDIC completely addressed all the issues raised in my complaint.
My complaint was completely resolved to my satisfaction.
If I had another problem involving a bank, I definitely would contact the FDIC again.
If friends or relatives had a problem involving a bank, I definitely would recommend the FDIC to them.

FDIC 6422/08 (12-05) (See Page 2 for the Estimated Reporting Burden)

The following questions will help us group your answers with other responses we receive to this survey and improve our outreach to consumers.
6. What is your gender?			Male		Female
7. In what year were you born?      
8. Please indicate your household’s total gross (before taxes) income for last year.
	Under $15,000			$60,001 - $75,000				$120,001 - $135,000
	$15,000 - $30,000			$75,001 - $90,000				$135,001 - $150,000
	$30,001 - $45,000			$90,001 - $105,000				Over $150,000
	$45,001 - $60,000			$105,001 - $120,000
9. Which of these categories do you feel best describes you? (Please check all that apply)
	White
	Black/African-American
	Hispanic/Latino
	American Indian/Alaska Native e
	Asian
	Native Hawaiian/Pacific Islander
	Other (please specify)	     
10. What is the highest level of education you have completed?
	Grade School
	Some high school
	High school graduate or GED
	Junior college or trade school graduate
	Some college
	College graduate
	Some graduate school
	Graduate school or graduate/professional degree
11. How many people are in your household?						     

Comments: Please use space below to share with us any other comments you would like to make concerning the FDIC’s investigation of your complaint. (If additional space is needed, attach a separate sheet.)

     

ESTIMATED REPORTING BURDEN

Paperwork Reduction Act Notice. Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the FDIC, Washington, DC 20429; and to the Office of Management and Budget, Paperwork Reduction Project (3064-0127), Washington, DC 20504.

FDIC 6422/08 (12-05) Page 2