| 1 |
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| Were you interviewed in person or over the phone? |
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□ IN PERSON |
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□ BY PHONE |
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(Go to Question 2a) |
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(Go to Question 2b) |
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| 2a |
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| For interviews conducted in person: |
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Was the Investigator dressed professionally and well groomed? |
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□ YES |
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□ NO |
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Did the Investigator show you credentials and introduce himself/herself |
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as a Special Agent or Investigator with the U.S. Office of Personnel Management? |
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□ YES |
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□ NO |
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Were you interviewed in private? |
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□ YES |
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□ NO |
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If "NO", please explain:_________________________________________________ |
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| 2b |
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| For interviews conducted by phone: |
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Did the Investigator introduce himself/herself as a Special Agent or Investigator |
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with the U.S. Office of Personnel Management? |
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□ YES |
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□ NO |
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Please check the reason for the telephone interview: |
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| □ MY REQUEST □ INVESTIGATOR'S REQUEST □ NO REASON GIVEN |
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| 3 |
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| Was the Investigator polite and professional? |
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□ YES |
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□ NO |
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| 4 |
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| Did the Investigator explain that the interview was for employment or security clearance purposes? |
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□ YES |
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□ NO |
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| 5 |
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| Were questions presented in a clear manner so that they could be understood easily? |
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□ YES |
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□ NO |
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| 6 |
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| The information you provided about the person being investigated (check one)… |
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□ ...was favorable. |
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□...included issues |
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or concerns. |
| If you told the Investigator about concerns regarding the person being investigated, briefly identify those concerns below: |
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| (For example--criminal conduct, illegal drug use, alcohol abuse, violent behavior, foreign travel) |
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| CONCERNS: |
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| 7 |
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| Please provide any additional comments or concerns you have about the interview, the investigation, or the investigator. |
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| Is it necessary for a representative from OPM to contact you? |
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□ YES |
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□ NO |
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| 8 |
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| Signature:________________________________________________ Date:_____________________________ |
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| Please provide your contact information: |
| Daytime telephone number: ( ) ________ - ____________ |
| Email address:__________________________________________ |
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