FDIC 6422/08, Consumer Satisfaction Questionnaire

Status: Original and derived artifacts are available for this document.

Download: doc | pdf | html


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.

    1.  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