Information Access Center (IAC) Customer Comment Card

CUSTOMER COMMENT CARD

FORM APPROVED OMB NO. 1090-0011

Expires: 06/30/2015

Date: ________________
Reason for your visit: ____________________________________________________

Please Rate: Poor Fair Good Excellent

1 . Quality of Service
2. Timeliness

3. Efficiency
4. Friendliness/Courtesy

5. Overall Experience
6. Please share one thing we could change that would improve your experience when

visiting the Information Access Center (IAC). ________________________________
______________________________________________________________________

______________________________________________________________________

**Please note additional comments on back of form.

Paperwork Reduction Act

The purpose of this survey is to provide information to the Bureau of Land Management for evaluating and improving the recreation

services and programs that it provides to the public. Response to this survey is voluntary. No action may be taken against you for

refusing to supply the information requested. The reporting burden for this form is estimated to average 1 minute, which includes the

time for reviewing instructions and completing and reviewing the form. 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 Office of Management and Budget (OMB) control

number. Please direct comments regarding the burden estimate or any other aspect of this form to: U.S. Department of the Interior,

Bureau of Land Management (1040-0001), Bureau Information Collection Clearance Officer (WO-630), 1849 C Street, N.W., Room

2134LM, Washington, D.C. 20240.

Privacy Act Statement

No Privacy Act Information is being collected; therefore, no direct link to the individual(s) filling out this survey will be available.

Information collected will be compiled to produce statistics.