FSA-441C APFO Service Quality Survey

This form is available electronically.
FSA-441C
U.S. DEPARTMENT OF AGRICULTURE
(09-05-12)
Farm Service Agency

Form Approved - OMB No. 0560-0176

APFO SERVICE QUALITY SURVEY
PRA Disclosure Statement – According to the Paperwork Reduction Act of 1995, no
persons are required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is
0560-0176. The time required to complete this information collection is estimated to
average five (5) minutes per response. If you have comments concerning the accuracy
of the time estimate(s) or suggestions for improving this form, please write to: USDAFSA Aerial Photography Field Office, Attn: Customer Service Supervisor, 2222 West
2300 South, Salt Lake City, Utah 84119-2020.

Aerial Photography Field Office
2222 W 2300 S
Salt Lake City, Utah
USA
84119-2020
Phone: 801-844-2922
Fax: 801-956-3653
http://www.apfo.usda.gov

Dear Valued Customer:
As part of our ongoing effort to improve our service, I invite you to participate in this Service Quality Survey.
We hope your recent experience has been a good one, but whether your opinion is positive or negative, we’d like to
hear from you. Your opinion is extremely important to us.
If it would be more appropriate for another person to complete this survey, please pass it along to them. Responses
can be submitted on site in the counter box, faxed to (801) 956-3641 (Attention: Customer Service Supervisor),
online (preferred method) at http://www.surveymonkey.com/s/fsa_441c_apfo_service_quality or you may complete,
save, and email this form directly to [email protected] by visiting http://www.apfo.usda.gov and click on
“Forms”.
Sincerely,

Customer Service Section Supervisor
COMPLETE SURVEY
1. The Aerial Imagery Specialist helping me was:

2. Order Number (If available)

3. Email Address

4. As for Customer Service, I am treated with courteous/tactful behavior with timely and accurate products/service in a positive professional manner.
Always

Usually

Seldom

5. Information or Communications are clear, correct, timely and presented in an understandable manner.
Always

Usually

Seldom

6. My time spent researching or requesting help was time well spent as I received the product without requiring revisions.
Always

Usually

Seldom

7. Comments

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status, parental status, religion, sexual orientation, political beliefs, genetic information, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited
bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at
(202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Assistant Secretary for Civil Rights, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop
9410, Washington, DC 20250-9410, or call toll-free at (866) 632-9992 (English) or (800) 877-8339 (TDD) or (866) 377-8642 (English Federal-relay) or (800) 845-6136 (Spanish Federal-relay). USDA is an equal
opportunity provider and employer.