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pdfMacro International/ScanTron
IRS Customer Survey
P.O. Box 64529
St. Paul, MN 55164-9614
[DATE]
Name1
Name2
Name3
Name4
Address
City, State, Zip
RE: ORGANIZATION NAME
Dear JOHN Q & MARY Q SAMPLE:
A few days ago you received a letter from IRS, Tax-Exempt and Government Entities Commissioner
Sarah Ingram asking for your help with an important research project. The Internal Revenue Service
(IRS) is committed to improving its performance and service to the American public. As part of this
process, we are administering a nationwide survey to gather reliable information from those who have
had contact with IRS employees and services.
Your name was selected through a scientific random sampling process to receive this survey because
IRS recently completed a determination of the tax-exempt status for your client. We want to know your
opinions regarding that experience and the service you received from IRS. Your responses are critical
to the accuracy of this evaluation of the IRS’s service. If another person was primarily responsible
for dealing with the IRS on this matter, please pass this survey on to them and encourage them to
respond.
Your participation is voluntary. An independent research company will keep your responses
confidential. Your responses will be grouped with others, so that no individual reply can be traced back
to a person or case number. No identifying information will be associated with your responses.
This brief survey should take less than 8 minutes to complete. Use the postage-paid reply envelope
to return your completed survey. If you have any questions or concerns, please feel free to call Macro
International toll free at 1-888-260-0052 or e-mail us at [email protected].
Thank you in advance for your cooperation. Your honest opinions will help bring about improvements in
service for all tax-exempt organizations.
Sincerely,
Larry Luskin
Project Director
Macro International Inc.
L2_12184-B_ POA
OMB# 1545-1432
Internal Revenue Service (IRS) Customer Satisfaction Survey
Exempt Organization Determination Letter Request
You can help the IRS improve its service to the public by answering the questions below. This voluntary survey takes less than
8 minutes to complete.
Your responses will be held confidential by the survey processing center and only aggregate information will be provided to
the IRS.
The following questions ask your opinion regarding your most recent IRS employee plan determination request. Regardless
of whether you agree or disagree with the final outcome, please mark the appropriate box on the scale (where 1 means “Very
Dissatisfied” and 7 means “Very Satisfied”) or next to the response that best applies to you.
Overall Satisfaction
Very
Dissatisfied
1
2
3
4
5
6
Very
Satisfied
Don’t Know
Not Applicable
7
1. Regardless of whether you agree or disagree with the final outcome,
how would you rate your overall satisfaction with the way your case
was handled by the IRS?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
2. Overall, how satisfied are you with the length of the process, from
submission of your application through final determination?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
3. Overall, how satisfied are you with how well the IRS communicated
with you throughout the process (whether in writing or by telephone)?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡
¡
¡
APPLICATION
How satisfied are you with…
4. The ease of locating the correct application form and instructions?
5. The ease of understanding the application form and instructions?
6. The ease of completing the application form?
7. The amount of time you had to spend completing your application?
Acknowledgement Letter (Confirming Receipt of Application)
Very
Dissatisfied
1
How satisfied are you with…
8. How quickly you received your acknowledgment letter?
9. How clearly the acknowledgement letter communicated the expected
timeframe until the IRS would contact you?
2
3
4
5
6
Very
Satisfied
Don’t Know
Not Applicable
7
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
10. Did the IRS contact you within the timeframe stated in the acknowledgement letter?
¡
¡
¡
Yes, I received a letter or telephone call within the stated timeframe.
No, I did not receive a letter or telephone call within the stated timeframe.
I initiated contact before the stated timeframe elapsed.
11. How satisfied are you with the amount of time it took for the IRS to
contact you (following your acknowledgement letter)?
Form 12184-B (Rev. 2-2009)
Cat. No. 26978G
Please continue on next page
Department of the Treasury-Internal Revenue Service
PLEASE COMPLETE THIS SECTION IF THE IRS CONTACTED YOU IN WRITING OR BY TELEPHONE
REGARDING YOUR DETERMINATION APPLICATION OR TO ASK FOR MORE INFORMATION.
Additional Information Request (After Receipt Of Acknowledgement Letter)
Very
Dissatisfied
1
12. Overall, how satisfied are you with the IRS agent assigned to
your case?
2
3
4
5
6
Very
Satisfied
Don’t Know
Not Applicable
7
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
17. Communications about the status of your determination?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡
¡
¡
¡
18. The consideration given to the information you presented
in the original application or submission?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
19. The description of the additional information the IRS
needed to complete your determination?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
21. The time given you to respond to additional IRS request(s)?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
¡
22. The amount of time you had to spend responding to IRS requests
for additional information?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
23. The timeliness of the IRS agent in responding to your inquiries?
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
How satisfied are you with…
13. The courtesy of the IRS agent?
14. The knowledge of the IRS agent?
15. How well the IRS agent listened to your concerns?
16. How thoroughly the IRS agent answered your questions?
20. The explanation of why additional information was requested?
Final Determination
Very
Dissatisfied
1
How satisfied are you with…
24. The ease of understanding the determination letter you received?
2
3
4
5
6
Very
Satisfied
Don’t Know
Not Applicable
7
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
Other Information
25. How many paid employees work for the organization for which this determination was sought?
None
1–9
10–99
100–499
500–999
1,000 or more
26. What are the estimated total assets of the organization for which this determination was sought?
Less than $1,000,000
$1,000,000 to $4,999,999
Form 12184-B (Rev. 2-2009)
$5,000,000 to $9,999,999
$10,000,000 or more
Cat. No. 26978G
Please continue on next page
Department of the Treasury-Internal Revenue Service
27. For this determination, were you . . .
¡
¡
An employee/officer of the organization [skip to Question 29]?
A designated third-party representative/power of attorney (POA)?
ANSWER ONLY IF YOU ARE A DESIGNATED THIRD-PARTY REPRESENTATIVE/POWER OF ATTORNEY (POA)
Very
Consistent
Very
Inconsistent
How satisfied are you with…
1
28. If you are a designated third-party representative/power of attorney,
how consistent was the IRS in its handling of this application
compared with other applications you have completed in the past year?
2
3
4
5
6
Don’t Know
Not Applicable
7
¡ ¡ ¡ ¡ ¡ ¡ ¡
¡
29. Did you visit the IRS website (www.irs.gov/eo) for assistance or information during the determination process?
¡
¡
Yes
No
Comments
30. If you have any suggestions for how the IRS can improve its service, or any other comments, please provide them below.
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
If you have any questions about this survey, please contact the survey processing center at 1-888-260-0052 or
[email protected].
!
If you have been unable to resolve any specific problems with your tax matter through the normal IRS channels,
or now face a significant hardship due to the application of the tax law, we encourage you to contact the Taxpayer
Advocate Service at 1-877-777-4778.
Thank you for completing the survey.
Paperwork Reduction Act Notice
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: Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP,
1111 Constitution Ave. NW, Washington, DC 20224.
Form 12184-B (Rev. 2-2009)
Cat. No. 26978R
Department of the Treasury-Internal Revenue Service
| File Type | application/pdf |
| File Modified | 2009-10-20 |
| File Created | 2009-09-24 |