United States Department of Agriculture
This form is available electronically. Form Approved - OMB No. 0560-0176
FSA-441C (proposal 2)
|
Farm Service Agency Aerial Photography Field Office
APFO SERVICE QUALITY SURVEY
|
|
|||
Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0560-0176. The time required to complete this information collection is estimated to average five (5) minutes per response. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: USDA-FSA Aerial Photography Field Office, Attn: Customer Service Supervisor, 125 South State Street Suite 6416, Salt Lake City, Utah 84138-1102. |
Aerial Photography Field Office 125 South State Street Suite 6416 Salt Lake City, Utah USA 84138-1102 Phone: 801-844-2922 Fax: 855-415-2014 |
||||
Dear Valued Customer:
As part of our ongoing effort to improve our service, I invite you to participate in this Service Quality Survey.
We hope your recent experience has been a good one, but whether your opinion is positive or negative, we’d like to hear from you. Your opinion is extremely important to us.
If it would be more appropriate for another person to complete this survey, please pass it along to them. Responses can be submitted on site, faxed to (801) 956-3653 (Attention: Customer Service Supervisor), or online at http://www.surveymonkey.com/s/fsa_441c_apfo_service_quality (preferred method). You may also complete, save, and email this form directly to apfo.sales@slc.usda.gov or by visiting http://www.apfo.usda.gov and then click the “Forms” tab then the survey link after opening the document.
Sincerely,
Customer Service Section Supervisor
|
|||||
COMPLETE SURVEY |
|||||
1. The Aerial Imagery Specialist helping me was: |
2. Order Number (If available) |
3. Email Address |
|||
|
|
|
|||
4. As for Customer Service, I am treated with courteous/tactful behavior with timely and accurate products/service in a positive professional manner.
Always Usually Seldom |
|||||
5. Information or Communications are clear, correct, timely and presented in an understandable manner.
Always Usually Seldom |
|||||
6. My time spent researching or requesting help was time well spent as I received the product without requiring revisions.
Always Usually Seldom |
|||||
7. Comments |
|||||
|
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | This form is available electronically |
Author | anita.crowell |
File Modified | 0000-00-00 |
File Created | 2021-01-21 |