Form SV-2014-0001 Premier Acceptance Facility Survey-ENGLISH

OMB Control No.: 1405-0193

OMB Expiration Date: xx/xx/xxxx

Estimated Burden: 3 minutes

SV-2014-0001

 

 

 

 

Customer Survey – Service Offerings for Passport Acceptance

We would like your feedback to help us evaluate what services are important to you. Your opinions matter to us. Please take a few minutes to complete this survey and indicate what best describes your opinions about service offerings at passport acceptance facilities. Thank you for your participation in this survey. If you prefer, you can complete this survey by phone by calling 1-855-865-7756 (toll free) Monday through Friday from 8:00 am to 10:00 pm Eastern Time excluding Federal holidays.

Date (month/day/year): ____/____/____ Time:_____________

1. On a scale from 0 to 10, with 0 being not at all important and 10 being extremely important, how important is it that an acceptance facility offers the following services or amenities?

Not at all Extremely

Important Important

1. Accessibility

(e.g., parking availability, 0 1 2 3 4 5 6 7 8 9 10

close to public transit, etc.)

2. Weekday evening hours

(e.g., after 5pm, Monday-Friday) 0 1 2 3 4 5 6 7 8 9 10

3. Weekend hours

(e.g., Saturday or Sunday) 0 1 2 3 4 5 6 7 8 9 10

4. Separate area for applicants

to fill out forms 0 1 2 3 4 5 6 7 8 9 10

5. Allowing customers to walk-in

without an appointment 0 1 2 3 4 5 6 7 8 9 10

6. Allowing customers to make

an appointment 0 1 2 3 4 5 6 7 8 9 10

7. Photo services 0 1 2 3 4 5 6 7 8 9 10

3) Why did you choose this facility? Please check all that apply.

• Its location (e.g., close to home, work, or other area)

• Recommended by friend/relative/co-worker

• Saw a flier, commercial, or other advertisement about the facility

• I was already coming here on other business

• Facility’s hours of operation

• Facility offers photo services

• Able to walk-in without an appointment

• Parking availability

• Close to public transit

• Handicap accessibility

• No specific reason

• Other: Please Specify:__________________________________

2. What other services or amenities would you like to see offered at acceptance facilities? Please write your comments in the space provided below.

3. Additional comments:

Public reporting burden for this collection of information is estimated to average 3 minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection. You do not have to supply this information unless this collection displays a currently valid OMB control number. If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to: AFSurvey@state.gov

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Facility Number