Surveys; CS-09-158C, CS-09-179, -180, -181, -182, -183, -184, -185, -186, -187, -188, -189, -190, -191, -192, -193, and CS-09-194

Appendix A

Language on the log-in screen of FSA computer workstations:

The actions you perform on this computer are being recorded for quality assurance purposes. Anonymity will be maintained. Your personal information will not be captured or retained.

Appendix B

Language on the initial screen of the customer survey:

Privacy Statement:

Answering survey questions for the Facilitated Self-Assistance Customer Satisfaction Survey is voluntary. If you choose to answer survey questions, your answers will be kept anonymous. You can skip any survey questions or stop answering survey questions at any time.

The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control Number for this study is 1545-1432. Also, if you have any comments regarding the time estimates associated with this study or suggestions on making this process simpler, please write to the:

Internal Revenue Service

Tax Products Coordinating Committee

SE:W:CAR:MP:T:T:SP

1111 Constitution Ave. NW, Washington, DC 20224

Appendix C

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Facilitated Self-Assistance Customer Satisfaction Survey

Instructions: For each question, please answer for the MAIN issue that brought you here today. The survey will take about 2 minutes. Thank you for trying our new service option and sharing your opinions about it.

1. What was the MAIN reason you visited this IRS office today? (Please select one)

 Free File or the Free File Fillable Forms Option

 Forms and Publications

 EIN Application

 Where's My Refund?

 Other (please specify) ______________________________

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2. What category describes your current age?

 18 to 24 years  45 to 54 years

 25 to 34 years  55 to 64 years

 35 to 44 years  65 years and over

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­

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3. Besides this IRS office, do you have access to the Internet?

 Yes

 No

 Don’t know

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4. How easy or difficult was it to find the information or conduct the transaction you needed?

 Very Easy

 Somewhat Easy

 Neutral

 Somewhat Difficult

 Very Difficult

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5. How satisfied or dissatisfied are you with the service you received today

 Very Satisfied

 Satisfied

 Neutral

 Dissatisfied

 Very Dissatisfied

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6. Were you able to get an answer to your question or complete your transaction?

 Yes -> if yes, skip to question 8

 No

 Don’t know

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7. If you were unable to get the service you needed, what was the MAIN reason? (Please select one)

 Could not find the information I needed

 Had problems with IRS computer (e.g., too slow, stopped working, could not print, etc.)

 Had problems with the Free-File website (e.g., too slow, stopped working, could not print, etc.)

 Did not have all the information I needed to complete my service task today

 I needed further clarification or assistance

 I became frustrated with the process and decided to quit

 Other (please specify) ______________________________

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8. Before today, which of the following IRS resources or services did you use to attempt to resolve the MAIN issue that brought you here today? (Please select all that apply)

 IRS forms and instruction booklets

 IRS website (www.IRS.gov)

 IRS office (Taxpayer Assistance Center)

 IRS phone representative

 Automated IRS phone system

 E-mail with the IRS

 Written correspondence with the IRS (Other than E-mail)

 None, this was my first IRS contact for my main issue

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9. In the future, would you use the IRS website (www.IRS.gov) again to get an answer or resolve your tax issue?

 Yes

 No

 Don’t know

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10. Do you have any additional comments? Please let us know how we can improve your experience.

Type comments and suggestions in the box below. (Maximum 256 characters)

Thank you for taking our customer survey! Your input will help us improve our services and make taxes easier.