Business (For- and Not-for-Profit)

Appendix E2

Round 2
Participating Independent Store Survey

OMB Control No: 0584-xxxx

Expiration Date: xx/xx/20xx

[STORE MANAGER/OWNER NAME AND ADDRESS]

[DATE]

Dear _________,

Thank you for being part of the Evaluation of the Healthy Incentives Pilot (HIP). You are one of a few retailers chosen to provide feedback about HIP. By responding to this survey, you are helping us learn how to make HIP better for retailers and Supplemental Nutrition Assistance Program (SNAP)/Food Stamp customers.

As an incentive, HIP pays back SNAP/Food Stamp customers in Hampden County a portion of their fruit and vegetable purchases in the form of a credit. The Massachusetts Department of Transitional Assistance (DTA) is running HIP, with funding from the Food and Nutrition Service (FNS) of the USDA. We are studying how HIP affects SNAP/Food Stamp customers and the community on the behalf of FNS.

There are 2 parts to this survey:

• Part 1: Store Manager/Owner Survey (estimated to take about 25-30 minutes) should be completed by the store manager or owner. The store manager or owner may consult other employees in the store to answer some of the survey questions. This part of the survey is yellow.

• Part 2: Checkout Supervisor Survey (estimated to take about 10 minutes) should be completed by the person who knows the most about checkout procedures. This person may be the manager or owner (for small stores) or the checkout supervisor (for medium and large stores). This part of the survey is blue.

Please call our toll-free number 1-800-xxx-xxxx if you need help filling out the survey or have any other questions. When you have finished the survey, please return it to us using the pre-paid business reply envelopes provided.

Thank you,

Susan Bartlett

Abt Associates Inc.

Public reporting burden for this collection of information is estimated to average 25-30 minutes for Part 1, and 10 minutes for Part 2, 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

OMB Control No: 0584-xxxx

Expiration Date: xx/xx/20xx

Part 1:

Store Manager/Owner Survey
Healthy Incentive Pilot (HIP) Evaluation

Please follow these instructions when filling out this survey.

• Please fill out the survey (Part 1) and mail back to us using the pre-paid business reply envelope

• Call toll-free number 1-800-xxx-xxxx if you need help filling out the survey

Please check the pre-printed label below. If any information is incorrect, cross it out and write in the correct information. Also, please write in the date for when you completed the survey. We will try to reach you at the phone number provided below if we have any follow-up questions.

All information in this survey will be kept private, except as otherwise required by law. We must tell FNS which stores we are contacting, but only the researchers at Abt—not FNS or other government agencies—will know your responses to the survey. Your responses are protected from disclosure under the Freedom of Information Act. We will not use your name or your store’s identity in any government reports or other publications. If you have questions about your rights as part of this study, you may contact Teresa Doksum at (877) 520-6835 (toll-free).

Public reporting burden for this collection of information is estimated to average 25-30 minutes for Part 1 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

Section A. About Your Store

Please answer these questions about the store you manage.

1. When is your store open?

For each day of the week, mark if your store is open for at least part of the day, or closed for the entire day.

Day of Week Check one box per row:	Open?	Closed for the day?
Sunday		
Monday		
Tuesday		
Wednesday		
Thursday		
Friday		
Saturday		

2. How many working cash registers are there in your store? _________

2a. Of these, how many accept EBT or Bay State Access cards (also known as Quest)?

_________

3. On average, what share of your store’s total food sales is made with SNAP/Food Stamps? (check the answer that best fits your store)

• Less than 10%

• 10% to less than 25%

• 25% to less than 50%

• 50% to less than 75%

• 75% or more

4. How often does your store promote fruits and/or vegetables using the activities listed below?

Activity Check one box for each row:	Never	My store does this activity less than once a month	My store does this activity once a month or more
Posters or signs in store window or outside			
Posters or signs elsewhere in store			
Shelf tags			
Coupons			
Recipes or fliers in store			
Fliers/ads in newspaper or direct mail			
Food samples			
Price or volume promotions			
Other Please specify: _______________________________			

5. Has your store developed any signs for HIP customers?

• Yes

• No

Now we would like to learn about what you think about the purpose of HIP and how it has affected your store.

6. How much do you agree or disagree with each of the statements below?

Check one box per row:	Strongly disagree	Somewhat disagree	Neither agree nor disagree	Somewhat agree	Strongly agree	Don’t know
I understand the purpose of HIP						
I understand how HIP is supposed to work						
It is important to improve the choices that people make when buying foods with SNAP/Food Stamps						
Training store workers for HIP has been a burden						
HIP purchases have been hard to process						
My store is paid on time for HIP purchases						
Payments to my store for HIP purchases are accurate						

You have completed Section A of the survey!
Please continue to Section B on the next page

Section B. How HIP Has Affected the Store

Now we would like to learn about how HIP has affected your store. We will first ask you about any operational problems with HIP in the past 3 months.

7. Have you had any problems knowing what food items are eligible for HIP? (check one)

• Yes

• N o  (Go to question 8)

7a. How often have you had problems?

• Once

• A few times

• Frequently

7b. Have the problems been resolved?

• Yes

• No

8. Have you had any problems having a current list of HIP eligible items in cash registers? (check one)

• Yes

• N o  (Go to question 9)

8a. How often have you had problems?

• Once

• A few times

• Frequently

8b. Have the problems been resolved?

• Yes

• No

9. Have you had any problems separating HIP-eligible food items from non-HIP food items? (check one)

• Yes

• N o  (Go to question 10 on the next page)

9a. How often have you had problems?

• Once

• A few times

• Frequently

9b. Have the problems been resolved?

• Yes

• No

(Go to question 10 on the next page)

10. Have you had any problems identifying HIP customers? (check one)

• Yes

• N o  (Go to question 11)

10a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

10b. Have the problems been resolved? (check one)

• Yes

• No

11. Have you had any problems computing the purchase amount for HIP items? (check one)

• Yes

• N o  (Go to question 12)

11a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

11b. Have the problems been resolved? (check one)

• Yes

• No

12. Have you had any problems processing sales of HIP items? (check one)

• Yes

• N o  (Go to question 13 on the next page)

12a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

12b. Have the problems been resolved? (check one)

• Yes

• No

(Go to question 13 on the next page)

13. Have you had any problems processing returns with HIP items? (check one)

• Yes

• N o  (Go to question 14)

13a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

13b. Have the problems been resolved? (check one)

• Yes

• No

14. Have you had any problems processing manual vouchers with HIP items? (check one)

• Y es

• N

   (Go to question 15 on the next page)

  o

• N ot applicable

14a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

14b. Have the problems been resolved? (check one)

• Yes

• No

(Go to question 15 on the next page)

15. Have you had any problems getting information about SNAP/EBT sales and settlement? (check one)

Settlement is when you use the EBT terminal or integrated cash register system to total up the EBT purchases for the day or for a cashier’s shift, and when the EBT system takes the total for the day and puts it in your bank account.

• Y es

• N

   (Go to question 16)

  o

• Don’t know

15a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

15b. Have the problems been resolved? (check one)

• Yes

• No

16. Have you had any problems responding to customer questions about HIP? (check one)

• Yes

• N o  (Go to question 17)

16a. How often have you had problems? (check one)

• Once

• A few times

• Frequently

16b. Have the problems been resolved? (check one)

• Yes

• No

17. Please describe any major problems you have had with HIP in the space below.

• My store has not had any major problems with HIP  (Go to question 19)

18. From the list below, who helped you fix any major problem in the past 3 months? How helpful were they?

• For each organization in Column (1), mark “yes” in Column (2) if you asked them for help or “no” if you did not ask them for help.

• If you marked “N” (no), move to the next row. If you marked “yes”, mark how helpful they were in Column (3).

(1) Organization	(2) Did you Ask for Help?	(3) How Helpful were They? (check one)
		Not Helpful	Helpful	Very Helpful
Department of Transitional Assistance (DTA/State Welfare Department—Eddie Gomez or others)	 Yes  No (Go to next row)			
Another State Agency (MA Department of Agriculture Resources (DAR), MA Department of Public Health (DPH), MA Office of Business Development (OBD))	 Yes  No (Go to next row)			
FNS/USDA office	 Yes  No (Go to next row)			
Affiliated Computer Systems (ACS, the EBT contractor for DTA—Bill Kelly or others)	 Yes  No (Go to next row)			
Novo Dia Group (Josh Wiles, Ricky Aviles or others)	 Yes  No (Go to next row)			
The company that provides terminals for EBT and other customer payments	 Yes  No (Go to next row)			
Other organization Please specify: ____________________________	 Yes  No			

19. Have you ever had to contact someone outside your store for help if a HIP customer had a problem making a purchase or return with their EBT card?

• Yes

• N o  (Go to question 20 on the next page)

19a. How many times in the past month have you had to ask someone outside your store for help if a HIP customer had a problem making a purchase or return with their EBT card?

_______ times in the past month  Don’t know

(Go to question 20 on the next page)

20. Overall, how satisfied are you with how HIP is working in your store? (check one)

• Very satisfied

• Somewhat satisfied

• Neither satisfied or dissatisfied

• Somewhat dissatisfied

• Very dissatisfied

21. Do you have any suggestions for how HIP operations could be improved?

Now we want to learn if HIP affected the amount of time and effort your store’s employees spend on checkout transactions.

22. Did HIP affect average checkout time in your store? (check one)

• Yes

• N o  (Go to question 23)

22a. How much was it affected? (check one)

 Large increase  Small increase  Small decrease  Large decrease

23. Did HIP affect the time and effort employees spent on settlement in your store? (check one)

Settlement is when you use the EBT terminal or integrated cash register system to total up the EBT purchases for the day or for a cashier’s shift, and when the EBT system takes the total for the day and puts it in your bank account.

• Yes

• N o  (Go to question 24)

23a. How much was it affected? (check one)

 Large increase  Small increase  Small decrease  Large decrease

24. Did HIP affect the time and effort employees spent on reconciliation? (check one)

Reconciliation is when you compare the EBT purchases recorded in your cash register to what is reported by the EBT terminal and what is deposited in your bank account.

• Yes

• N o  (Go to question 25)

24a. How much was it affected? (check one)

 Large increase  Small increase  Small decrease  Large decrease

25. Did HIP affect the time and effort employees spent on store returns? (check one)

• Yes

• N o  (Go to question 26 on the next page)

25a. How much was it affected? (check one)

 Large increase  Small increase  Small decrease  Large decrease

(Go to question 26 on the next page)

Next, we would like to learn about how HIP has affected your store’s sales and profits since October 2011.

26. How has HIP affected your sales of fruits and vegetables since October 2011? (check one)

• Large increase in sales of fruits and vegetables

• Small increase in sales of fruits and vegetables

• No change in sales of fruits and vegetables

• Small decrease in sales of fruits and vegetables

• Large decrease in sales of fruits and vegetables

27. Thinking of how HIP has affected your store’s costs and sales, how has HIP affected your store’s profits? (sales minus costs) since October 2011? (check one)

• HIP increased profits

• HIP decreased profits

• No difference

• Don’t know

28. If you had it to do again, would you still join HIP? (check one)

• Yes

• No

You have completed Section B of the survey!
Please continue to Section C on the next page

Section C. Fruit and Vegetable Inventory

Instructions to Store Manager/Owner: You may consult your store’s produce or stocking manager to complete this section. If someone else completes this section, please have the person fill in the box below.

Please write in the requested information in the box below. We will try to reach you at the phone number provided below if we have any follow-up questions.

Please refer to the survey cover sheet for important information about how this survey will be used and how information will be kept confidential.

In this final section of the survey, we would like to ask you about the fruits and vegetables on display in your store.

29. First, does your store have any fresh fruits and vegetables available for customers to buy right now?

• Yes

• No  (Go to question 30)

29a. Please go to the area of your store where fresh fruits and vegetables are displayed. Read the instructions below and fill out the table about fresh fruits and vegetables in your store right now.

• For each food item in Column (1), mark “yes” if you have the item right now in your store or “no” if not.

• If “no”, move to the next item.

• For each item where you marked “yes”, print the most popular type of that food in Column (3) and the price per unit in Column (4). Some common units are a pound of apples, a head of lettuce or a single piece of fruit.

EXAMPLE – DO NOT WRITE HERE
The example below shows how to fill out the grid for a store that has Red Delicious apples for $1.29 a pound and iceberg lettuce at $0.79 a head, but does not sell oranges.
(1) Item	(2) Have now?	(3) Most Popular Type Sold (please specify)	(4) Price per Unit
Apples	 Yes  No (Go to next row)	Red Delicious	$ 1.29 / lb
Lettuce	 Yes  No (Go to next row)	Iceberg	$ 0.79/ head
Oranges	 Yes  No (Go to next row)		$ ___.____ / _____

Please fill in this grid:

(1) Item	(2) Have now?	(3) Most Popular Type Sold (please specify)	(4) Price per Unit
Apples	 Yes  No (Go to next row)		$ ___.____ / __________
Bananas	 Yes  No (Go to next row)		$ ___.____ / __________
Oranges	 Yes  No (Go to next row)		$ ___.____ / __________
Grapes	 Yes  No (Go to next row)		$ ___.____ / __________
Carrots	 Yes  No (Go to next row)		$ ___.____ / __________
Tomatoes	 Yes  No (Go to next row)		$ ___.____ / __________
Broccoli	 Yes  No (Go to next row)		$ ___.____ / __________
Lettuce	 Yes  No		$ ___.____ / __________

30. Does your store have plain canned or dried fruits/vegetables with no added sugar, oil or fats available for customers to buy right now?

• Yes

• No  (Go to question 31 on the next page)

30a. Please go to the area of your store where canned and dried fruits and vegetables are sold. Read the instructions below and fill out the grid to provide information on the food items in cans, jars or packages that are available to customers in your store right now.

• For each of the foods in Column (1), mark “yes” if you sell this item or “no” if not.

• If “no”, move to the next row. If “yes”, pick the container (can, jar, package) that is most popular.

• Print the size of the container in Column (3) and its price in Column (4).

EXAMPLE – DO NOT WRITE HERE
The example below shows how to fill out the grid for a store that sells 8.75 oz cans of diced tomatoes and does not sell canned whole kernel corn.
		For the most popular container…
(1) Item	(2) Have now?	(3) Size?	(4) Price?
Canned tomatoes (diced, crushed, whole)	 Yes  No (Go to next row)	8.75 oz	$ 0.49
Canned whole kernel corn	 Yes  No (Go to next row)	____ oz	$ ______._____

Please fill in this grid:

		For the most popular container…
(1) Item	(2) Have now?	(3) Size?	(4) Price?
Canned tomatoes (diced, crushed, whole)	 Yes  No (Go to next row)	______ oz	$ ________._________
Canned whole kernel corn	 Yes  No (Go to next row)	______ oz	$ ________._________
Canned green peas	 Yes  No (Go to next row)	______ oz	$ ________._________
Applesauce (“unsweetened” or “no sugar added”)	 Yes  No (Go to next row)	______ oz	$ ________._________
Canned pineapple (“no sugar added” or “in 100% juice”)	 Yes  No (Go to next row)	______ oz	$ ________._________
Raisins	 Yes  No	______ oz	$ ________._________

31. Does your store have plain frozen fruits and vegetables with no added sugars, sauce, butter or salt available for customers to buy right now?

• Yes

• No  (Go to question 32 on the next page)

31a. Please go to the area of your store where frozen fruits and vegetables are sold. Read the instructions below and fill out the grid to provide information on food items that are available to customers in your store right now.

• For each of the foods in Column (1), mark “yes” if you sell this item or “no” if not.

• If “no”, move to the next row. If “yes”, pick the package (bag or box) that is most popular.

• Print the size of the container in Column (3) and its price in Column (4).

EXAMPLE – DO NOT WRITE HERE
The example below shows how to fill out the grid for a store that sells 14 oz bags of frozen sliced strawberries, but no frozen peaches.
		For the most popular package…
(1) Item	(2) Have now?	(3) Size?	(4) Price?
Frozen strawberries (sliced or whole, “no sugar added”)	 Yes  No (Go to next row)	14 oz	$ 2.49
Frozen peaches (sliced, “no sugar added”)	 Yes  No (Go to next row)	____ oz	$ ______._____

Please fill in this grid:

		For the most popular package…
(1) Item	(2) Have now?	(3) Size?	(4) Price?
Frozen strawberries (sliced or whole, “no sugar added”)	 Yes  No (Go to next row)	______ oz	$ ________._________
Frozen peaches (sliced, “no sugar added”)	 Yes  No (Go to next row)	______ oz	$ ________._________
Frozen green beans	 Yes  No (Go to next row)	______ oz	$ ________._________
Frozen kernel corn	 Yes  No	______ oz	$ ________._________

Think back a year ago to when HIP began. We would like to learn how stocks and sales of fruits and vegetables have changed since October 2011. You may consult your store’s produce manager or stocking manager to complete this question.

32. Since October 2011, has your store changed how much food it stocks in each of the categories below? Does your store stock more, the same amount or less?

(1) Category	(2) Has Stock Changed since October 2011?
Check one box per row:	Stock more	Stock is the same	Stock less
Fruits:
Fresh			
Canned			
Frozen			
Dried			
Vegetables:
Fresh			
Canned			
Frozen			

If you DO NOT “stock more” for any of the food categories listed above, go to Question 33 on the next page.

32a. For the food categories where your store stocks more items, why did this happen? (check all that apply)

• My store has different customers

• My store has more customers

• My customers want more fruits and vegetables

• I/We want to promote fruits and vegetables

• Other reason Please specify:

33. Have you done any of the following since October 2011 so that you can sell more fruits and vegetables?

Check one box per row:	Yes	No	Don’t know
Started working with a new supplier			
Received more shipments from a supplier			
Increased frequency of restocking display floor			
Installed new refrigeration or freezer units for storage or display			
Increased shelf space			
Changed where food items are located in store or on shelves			

Next Steps:

• YOU HAVE COMPLETED PART 1: STORE MANAGER/OWNER SURVEY!

• PLEASE MAIL THE COMPLETED SURVEY BACK TO US AS SOON AS YOU CAN USING THE POSTAGE-PAID BUSINESS REPLY ENVELOPE PROVIDED.

• GIVE PART 2: CHECKOUT SUPERVISOR SURVEY TO THE PERSON WHO KNOWS THE MOST ABOUT CHECKOUT PROCEDURES. THIS COULD BE YOU (STORE MANAGER/OWNER), A CHECKOUT SUPERVISOR OR A FRONTLINE MANAGER.

• CALL TOLL-FREE 1-800-XXX-XXXX IF YOU HAVE ANY QUESTIONS.

THANK YOU FOR FILLING OUT THIS SURVEY!

OMB Control No: 0584-xxxx

Expiration Date: xx/xx/20xx

Part 2:

Checkout Supervisor Survey

Healthy Incentive Pilot (HIP) Evaluation

Instructions to Store Manager/Owner: The person who knows the most about checkout procedures should complete this part of the survey. This person may be you, a checkout supervisor or a frontline manager. If this person is not you, please have this person fill in the box below.

Please follow these instructions when filling out this survey.

• Wait until training has been completed in the local store before filling out the survey

• Please fill out the survey (Part 2) and mail back to us using the pre-paid business reply envelope

• Call toll-free number 1-800-xxx-xxxx if you need help filling out the survey

Please check the pre-printed label below. If any information is incorrect, cross it out and write in the correct information. Also, please write in the date for when you completed the survey. We will try to reach you at the phone number provided below if we have any follow-up questions.

All information in this survey will be kept secure and private, except as otherwise required by law. We must tell FNS which stores we are contacting, but only the researchers at Abt—not FNS or other government agencies—will know your responses to the survey. Your responses are protected from disclosure under the Freedom of Information Act. We will not use your name or your store’s identity in any government reports or other publications. If you have questions about your rights as part of this study, you may contact Teresa Doksum at (877) 520-6835 (toll-free).

Public reporting burden for this collection of information is estimated to average 10 minutes for Part 2 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Research and Analysis, 3101 Park Center Drive, Room 1014, Alexandria, VA 22302 ATTN: PRA (0584-xxxx). Do not return the completed form to this address.

Section A. About Your Store

First, think back to when HIP first started.

1. How satisfied are you with how you were trained for HIP? (check one)

• Very satisfied

• Somewhat satisfied

• Somewhat dissatisfied

• Very dissatisfied

Now please provide the following information about HIP training in your store.

2. Is training for HIP included as part of the training for new employees? (check one)

• Yes

• No

• The store does not have new employees

3. How often has your store offered HIP training refreshers for employees? (check one)

• Never since the training in Fall 2011

• Once or twice since HIP began in Fall 2011

• Three times or more since HIP began in Fall 2011

4. Have you yourself had a HIP training refresher since Fall 2011? (check one)

• Yes

• No

You have completed Section A of the survey!
Please continue to Section B on the next page

Section B. Questions About HIP

5. How often have you asked for information from another employee in your store or someone outside your store in the past 3 months about each of the following?

Check one box per row:	Never in the past 3 months	1-2 times in the past 3 months	3-10 times in the past 3 months	More than 10 times in the past 3 months	Don’t know
Knowing what food items are eligible for HIP					
Having a current list of HIP eligible items in cash registers					
Separating HIP food items from non-HIP food items					
How to identify HIP customers					
Computing subtotal for HIP items					
Processing sales with HIP items					
Processing returns of HIP items					
Processing manual vouchers with HIP items					
Getting information about SNAP/EBT sales					
Responding to customer questions about HIP					

6. How often have other employees in the store asked you questions in the past 3 months about each of the following?

Check one box per row:	Never in the past 3 months	1-2 times in the past 3 months	3-10 times in the past 3 months	More than 10 times in the past 3 months	Don’t know
Knowing what food items are eligible for HIP					
Having a current list of HIP eligible items in cash registers					
Separating HIP food items from non-HIP food items					
How to identify HIP customers					
Computing subtotal for HIP items					
Processing sales with HIP items					
Processing returns of HIP items					
Processing manual vouchers with HIP items					
Getting information about SNAP/EBT sales					
Responding to customer questions about HIP					

7. In the past 3 months, how often did your HIP customers ask you or other store staff questions about HIP? (check one)

• N ever  (Go to question 8 on the next page)

• Once in a while

• Frequently (once a week)

• Very frequently (more than once a week)

7a. What are the most common questions about HIP? (check all that apply)

• Knowing what food items are eligible for the HIP incentive

• Credit to EBT account

• Reading receipt/understanding balance

• Other questions Please specify: _______________________________________________________________

_______________________________________________________________

(Go to question 8 on the next page)

8. In the past 3 months, how often did SNAP customers who are not HIP customers ask about HIP? (check one)

• N ever  (Go to question 9)

• Once in a while

• Frequently (once a week)

• Very frequently (more than once a week)

8a. What questions did SNAP customers who are not HIP customers ask about HIP?

9. Have there been any questions from HIP or regular SNAP customers about HIP that you did not know how to respond to? (check one)

• Yes

• No  (Go to END)

9a. Please describe the questions they asked in the space provided below.

9b. Who did you refer them to?  Did not refer them to anyone

• Local DTA office

• ACS hotline

• DTA hotline

• Other Please specify: ______________________________

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