Customer Service Appointment Survey

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

G1451-FRM-POCApproved-08202014

Customer Service Appointment Survey

OMB: 1615-0121

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Customer Service Appointment Survey
Department of Homeland Security
U.S. Citizenship and Immigration Services

USCIS
Form G-1451
OMB No. 1615-0121
Expires 12/31/2014

Part 1. Appointment Location and Reason
1.

Date

2.

3.

Reason For Visit

Biometrics

Office Location
I-485 Interview

N-400 Interview

InfoPass

Other

Part 2. Information About Your Visit
1.

How long was your appointment?
10 minutes
20 minutes
or less
or less

30 minutes
or less

More than
30 minutes

2.

Did you have to wait long past your appointment
to see an officer?

Yes

No

3.

Did you understand the officer's questions?

Yes

No

4.

Were all of your questions answered?

Yes

No

5.

Do you know the next step in your process?

Yes

No

6.

Do you understand the directions you received?

Yes

No

7.

How many times have you visited USCIS for answers about
today's topic?
This is my first visit
2-3 times
More than 3 times

Paperwork Reduction Act
An agency may not conduct or sponsor an information collection and a person is not required to respond
to a collection of information, unless it displays a currently valid OMB control number. The public
reporting burden for this collection of information is estimated at 3 minutes per response, including the
time for reviewing instructions and completing and submitting the survey. Send comments regarding
this burden estimate, or any other aspect of this collection of information, including suggestions for
reducing this burden, to: U.S. Citizenship and Immigration Services, Regulatory Coordination Division,
Office of Policy and Strategy, 20 Massachusetts Ave NW, Washington, DC 20529-2140; OMB No.
1615-0121. Do not mail your completed Form G-1451 survey to this address.

PLEASE DO NOT SIGN THIS SURVEY
Form G-1451 08/04/14

Page 1 of 1

NO RETURN ADDRESS
FIRST CLASS
POSTAGE

District 10
U.S. Citizenship & Immigration Services
5629 Hoover Boulevard
Tampa, FL 33634


File Typeapplication/pdf
File Modified2014-08-20
File Created2014-08-20

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