Survey Notice

U.S. OFFICE OF SPECIAL COUNSEL
1730 M Street, N.W., Suite 218
Washington, D.C. 20036-4505
202-254-3600

{1MonthGenerateSurvey}/{2DayGenerateSurvey}/{3YearGenerateSurvey}

TO: RECIPIENTS OF OFFICE OF SPECIAL COUNSEL SURVEY

A matter that you filed with the Office of Special Counsel (OSC) was closed during fiscal year (FY)
{4?@FiscalYearWanted} (Oct. 1, {5BeginDateYear}-Sep. 30, {6EndDateYear}). To better serve you and
others who come to OSC for assistance, we hope that you will take a few minutes to complete our electronic
survey.
The nature of your contact with OSC falls into one of four categories, which you will be asked to identify
when you begin the survey:
1.
2.
3.
4.

a Prohibited Personnel Practice (PPP) complaint;
a written Advisory Opinion concerning the Hatch Act (HA);
a Uniformed Services Employment and Reemployment Rights Act (USERRA) complaint; or
a Whistleblower Disclosure (DU).

You are free to respond, or not to respond, to this survey. If you decide to respond, please fill out a
survey online, https:/www.research.net/s/V3GY62P
Prompt submission of the survey will ensure that your responses are included in our tabulations of survey
results. The online survey will be available for 60 days from the postmarked date of the envelope containing
this letter.
If more than one matter that you filed was closed by OSC in FY {7?@FiscalYearWanted}, you will
receive separate correspondence with unique survey access numbers - one for each matter closed. The type of
matter you submitted is indicated by one of the following four acronyms which appear below the zip code on
the address label of your envelope: PPP, HA, USERRA, and DU.
The OSC unit that administers the survey electronically does not handle questions or correspondence
about individual cases. If you have any questions, or need additional information about OSC services, please
call (800) 872-9855. Any of our representatives will be pleased to help you. You can also find information
about OSC on our Web site. The address is: https://osc.gov.

To access the survey electronically, use the following electronic address:
https://www.research.net/s/V3GY62P
On the screen which opens up, insert your FY {8?@FiscalYearWanted} survey number:

{9num}
OSC would like to thank you for your participation in its annual survey.

Paperwork Reduction Act Notice: OSC is asking for the information in this form because §
13 of Public Law 103-424 (1994) requires OSC to conduct an annual survey program, and
because the information received will help OSC in its ongoing efforts to provide better
service. OSC will use survey results to: (1) evaluate satisfaction with service provided in
connection with its receipt of complaints; (2) increase staff awareness of perceptions of
service provided; (3) identify areas where improvements can be made, and (4) provide a
summary of survey results in its annual report to Congress. Survey forms are not filed or
retrieved by personal identifiers such as names or case numbers. Respondents are not asked
to provide their name, case number, or other personally identifying data, therefore, no such
information will be used in the summary of survey results that OSC is required to include in
its annual report to Congress. You are not required to participate in the survey, and your
response is not required to obtain or keep any benefit. OSC estimates that the average
burden of this collection of information on you will be 12 minutes. If you would like to
comment on the accuracy of this estimate, or suggest ways to reduce it, please send your
comments or suggestions to: Survey Coordinator, Office of Special Counsel, 1730 M Street,
N.W., Suite 218, Washington, DC 20036-4505. Finally, an agency may not conduct or
sponsor, and you are not required to respond to, a collection of information unless it displays
a currently valid OMB control number.