OMB #1549-1349
SCREENER GUIDE
Form 9465 (SP)
Hello, my name is ___________. I am calling on behalf of IFC Macro, a research and consulting firm in the Washington DC area. We are working with the Internal Revenue Service (IRS) to obtain feedback on a revised form they are developing. We are seeking participants for a focus group we are holding in [insert city]. The total time to participate in the focus group will be no more than 2 hours. Your Participation voluntary.
IF ASKED: (EACH INTERVIEWER WILL HAVE THIS INFORMATION)
If respondents ask how their name was obtained, tell them their phone number was randomly selected from a list of individuals in the local calling area. If respondents are concerned about participating, tell them that our contract with the IRS specifically prohibits me from revealing their name or any information about them to the IRS or anyone else. Participation in this focus group will not affect your taxes or filing status.
This project has been approved by the U.S. Office of Management and Budget (OMB). The OMB Clearance Number is 1545-1349. If you like, I can give you a name and address where you can send comments and questions regarding these time estimates or suggestions for making this process simpler.
Internal Revenue Service
Tax Products Coordinating Committee
1111 Constitution Ave, NW IR-6526
SE:W:CAR:MP:T:T:SP
Washington, DC 20024
Your answers to these questions will be held completely private to the extent allowed by law by IFC Macro, meaning we will not provide your name or any identifying information to the IRS.
Are you bilingual?
Yes.
No (Terminate)
Do you speak Spanish?
Yes.
No (Terminate)
3. Are you able to read Spanish fluently?
Yes
No (Terminate)
4. How comfortable are you speaking and reading in English? (Please recruit a mix)
Very comfortable
Somewhat comfortable
I am uncomfortable speaking or reading English
I cannot read or speak English (Terminate)
5. Did you file a Form 1040, U.S. Individual Income Tax Return (Long Form), Form 1040A (Short Form) or Form 1040-EZ for tax year 2011?
Yes
No (Terminate)
6. Have you filed a Form 9465, Installment Agreement Request in the past 2 years?
Yes (Skip to question 10)
No (Terminate)
For Tax Practitioners
7. Are you a self employed tax practitioner?
Yes
No (Terminate)
8. Have you prepared at least 25 federal tax returns for your Spanish speaking clients?
Yes
No (Terminate)
9. Have you prepared Form 9465, Installment Agreement Request in the past 12 months for your Spanish speaking clients?
Yes
No (Terminate)
Into which of the following categories does your age fall? May opt-out if they wish to.
( ) less than 18 Terminate
( ) 18 to 33
( ) 34-44
( ) 45 to 64
( ) 65 and older
What was your filing status on your most recent tax return? [Read responses and check one]
( ) Single
( ) Married/jointly
( ) Head of household
( ) Widow/widower
12. Please identify your highest completed level of education. [May opt-out if they wish to.]
( ) Less than 9th grade
( ) 9th grade to 12th grade, no diploma
( ) High school graduate (or GED)
( ) Some technical or vocational school
( ) Technical or vocational school graduate
( ) Some college, no degree
( ) Associate Degree
( ) Bachelor’s Degree
( ) Master’s Degree
( ) Post-Master’s Degree
So that we can be sure that all backgrounds are represented in our project, could you please tell me the race and ethnic origin you identify with [1 or more responses OK; may opt-out if they wish to].
13. Are you of Hispanic or Latino origin (ethnicity)?
( ) Yes (Skip to Question 14)
( ) No
What is your race? Please select one or more.
( ) White
( ) Black or African American
( ) Asian
( ) Native Hawaiian or Other Pacific Islander
( ) American Indian or Alaska Native
Which of these categories does your total annual household income fall into?
( ) Less than $10,000
( ) $10,000 but less than $15,000
( ) $15,000 but less than $25,000
( ) $25,000 but less than $35,000
( ) $35,000 but less than $50,000
( ) $50,000 but less than $75,000
( ) $75,000 but less than $100,000
( ) $100,000 or more
Record Gender—DO NOT ASK UNLESS UNABLE TO DETERMINE; may opt-out if they wish to.
( ) Female
( ) Male
Thank you for answering our questions. Based on your responses, we would like to invite you to participate in a focus group which will be held in [insert city] [insert date] at [insert time]. We will provide everything that you need to participate in the focus group. Your participation is completely voluntary.
17. Are you willing to participate?
( ) Yes Continue
( ) No Terminate
Invitation
I’m glad that you will be able to join us! We will provide you with a $75 stipend as well as a light meal and refreshments. At this point I need to collect some contact information from you. Then we will call you the day before the session to confirm you will attend the session.
We are only inviting a few people, so it is very important that you notify us as soon as possible if for some reason you are unable to participate. Please call [insert recruiter contact and phone] if this should happen. We look forward to having you participate on [insert day] at [insert time].
Do you have any questions?
Great! Thank you for your time and we will be in touch again the day before the focus group. Please remember to bring reading glasses if you use them.
TERMINATE TEXT
Thank you very much for your time, and thank you for answering our questions. Unfortunately, based on the focus group requirements, we cannot extend you an invitation. Perhaps at a later time we can include you in a future focus group. Have a good [day/evening].
Basic Confirming Script
For use on all confirmation calls:
“Hi, this is _________ calling from [Facility Name]. We are calling to confirm your attendance for your upcoming [focus group/interview] that is taking place on [Date/Time].
We would just like to remind you to please arrive at the facility at least 15 minutes early, so that you have enough time to sign-in and be seated so that the group can start promptly.
If anything changes and you are either unable to make it, or have any other last minute questions, please do not hesitate to contact us. Please just remember that the dress code is business casual, and you will need to bring a photo ID for identity verification purposes. We look forward to seeing at the upcoming session. Thank you and have a great day.”
Moderator’s Guide
Focus Group Moderator’s Guide
Form 9465
Installment Agreement Request
INTRODUCTION
Introduction of the moderator
Good evening. My name is <insert first name> and I will be your moderator for this session. I work for ICF Macro, a research firm located near Washington, DC. We have been hired by the Internal Revenue Service (IRS) to moderate this discussion. You have been invited here because the IRS is interested in hearing your opinions about a form the Tax Forms and Publications Division of the IRS is revising. We will be talking about Form 9465(SP), Installment Agreement Request.
First, I would like to thank all of you for coming in tonight. Our discussion will take about two hours. Your comments and suggestions are very important to us and the IRS will make changes to Form 9465(SP) based on comments from this focus group and others
Explanation of the purpose of the focus group approach—to explore in a semi-structured manner what people think about the issues.
The group discussion of the issues often generates deeper insights than individual one-on-one interviews.
A topic oriented discussion of issues allows the participants to identify the important dimensions that might be lost in a structured interview setting.
It’s interactive so that the participants can talk back to us—ask what we mean, tell us when a question doesn’t make any sense, or means different things to different people.
BASIC GROUND RULES
Everything that you say here will be kept strictly private to the extent allowed by law. We will use first names only and names will not be used in the report. You will remain anonymous and are free to tell me what you think.
For the IRS to speak with the public, we are required to have approval from the Office of Management and Budget. Their approval number for this project is 1545-1349. Also, if you have any comments regarding the time estimates associated with this study or suggestions on making this process simpler, please write to the: IRS Tax Products Coordinating Committee, 1111 Constitution Avenue, NW, IR-6526, Washington, DC 20224.
We are audio-taping the meeting for use in preparing a report about findings. Your name will not be used in the report; but the tapes will help me remember the valuable input you give me to share with the Service. [Note to moderator: if anyone voices concern, also mention that the note taker cannot write as fast as participant’s speak nor can you remember everything after traveling to the three different cities over several months.]
Because we are taping this meeting, I ask that you speak loudly and clearly. If I think you are speaking too softly to be heard on the tape, I will ask you to speak up.
Please speak just one at a time so everyone has a chance to participate.
Don’t engage in side conversations—we need for everyone to hear what the others are saying and for everything that’s said to be heard easily on the tape.
Sometimes I’ll go around the table and ask everyone for their input. At other times, I will just throw a topic open for general discussion.
Participation—we need to get a full range of opinions, and we need everyone’s participation. You are here to talk. I am here to listen. I am not an expert in tax law so I cannot answer questions that involve tax law represented in Form 9465.
No evaluation—there are no right and wrong answers. We expect differences in how people see things, and we need to know about these differences.
Feel free to disagree or question each other. The purpose of a group session is that we learn things in group interchanges that we don’t get out of one-on-one discussions. If someone says something you disagree with, please let us know.
If you have a cell phone, please turn it off, or set it to vibrate. We don’t want the group to be disturbed and we also need your full attention during the session.
The session will last about two hours.
INTRODUCTION OF PARTICIPANTS
Let’s go around the table.
Individual Filers: Please introduce yourself (first name only, please) and tell us your nationality. Also tell us when you have filled out Form 9465(SP).
Tax Preparers: Please introduce yourself (first name only, please) and tell us how many returns you prepare each year for your clients, what counties do your clients come from and your nationality.
The IRS wants to get your feedback on several different translations of Form 9465(SP). I will be asking you questions about 3 different translations of the Form and Instructions.
Moderator: Hand out Version 1 (Yellow Version) of the translation of the Form 9465 (SP) and Instructions
The first thing I’m going to ask you to do is read a Form and Instructions.
Then, I’m going to ask you some specific questions about the information contained within the Form and Instructions.
Please take 10 minutes to read the Form and Instructions. When the time is up, I will let you know so we can begin the discussion. There is a pad of paper and a pen next to you so you can write down any observations or questions you may have about the Form or Instructions as your read them. If there are any words that are not understandable to you or appear out of context, please note that as well.
Do you have any questions before we begin?
Moderator, please give the participants 10 minutes to read the Form and Instructions and then begin the questioning.
What is your initial impression of Version 1, which we are going to call the Yellow Version of Form 9465(SP) and Instructions?
How easy is it to understand the language on the Yellow Version the Form 9465(SP) and Instructions?
Probe – Are there any words that are confusing?
Probe – If there are words that are confusing can you suggest changes to make it easier to read?
Now that you have read the Yellow Version of the Instructions, do you think it would help you complete the form?
Probe – If not, what could we change in the Instructions to make it easier to understand?
Was there anything in the translation of this version of the Form or Instructions that made it difficult to read or understand?
Probe: If so, can you provide suggestions for improving the wording to make the Form or Instructions easier to understand?
Is there anything you feel we could improve to make the Form more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
Is there anything you feel we could improve to make the Instructions more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
Moderator: Please take a count
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand this Yellow Version of the Form?
Probe: What was it about the Form that led you to your decision?
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand the Yellow Version of the Instructions?
Probe: What was it about the Instructions that led you to your decision?
Moderator: Hand out the Version 2 (Blue Version) of the translation of the Form 9465(SP) and give the participants 10 minutes to read.
How easy is it to understand the language on Version 2, the Blue Version of the Form 9465 (SP) and its instructions?
Probe – Are there any words that are confusing?
How easy is it to understand the language on the Blue Version the Form 9465(SP) and instructions?
Probe – Are there any words that are confusing?
Probe – If there are words that are confusing can you suggest changes to make it easier to read?
Now that you have read the Blue Version of the instructions, do you think it would help you complete the form?
Probe – If not, what could we change in the instructions to make it easier to understand?
Was there anything in the translation of this version of the Form or Instructions that made it difficult to read or understand?
Probe: If so, can you provide suggestions for improving the wording to make the Form or Instructions easier to understand?
Is there anything you feel we could improve to make the Form more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
Is there anything you feel we could improve to make the Instructions more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand the Blue Version of the Form?
Probe: What was it about the Form that led you to your decision?
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand the Blue Version of the Instructions?
Probe: What was it about the Instructions that led you to your decision?
Moderator, please give the participants 10 minutes to read Version 3 (Pink Version) of the Form and Instructions and then begin the questioning.
What is your initial impression of Version 3, which we are going to call the Pink Version of Form 9465(SP) and instructions?
How easy is it to understand the language on the Pink Version the Form 9465(SP) and Instructions?
Probe – Are there any words that are confusing?
Probe – If there are words that are confusing can you suggest changes to make it easier to read?
Now that you have read the Pink Version of the Instructions, do you think it would help you complete the Form?
Probe – If not, what could we change in the Instructions to make it easier to understand?
Was there anything in the translation of this version of the Form or Instructions that made it difficult to read or understand?
Probe: If so, can you provide suggestions for improving the wording to make the Form or Instructions easier to understand?
Are there any sections of the Pink Version of the Form that are confusing to you or you had difficulty understanding as you read it?
Probe: If so, what sections gave you problems?
Is there anything you feel we could improve to make the Form more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
Is there anything you feel we could improve to make the Instructions more understandable?
Probe: Is there anything you particularly liked or disliked?
Probe: If so, what and why?
Moderator: please take a count
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand this Pink Version of the Form?
Probe: What was it about the Form that led you to your decision?
On a scale of 1 to 5, with1 being very easy and 5 being very difficult, how easy or difficult was it for you to understand the Pink Version of the Instructions?
Probe: What was it about the Instructions that led you to your decision?
False close
Explain that participants can discuss among themselves the answers while you check in with the observers to see if they have any addition questions they would like you to ask.
Closing
Thinking about our discussion tonight, is there anything else you would like to share regarding the Forms and Instructions we looked at today.
Thank you very much for coming this evening, and for sharing your ideas with us—we really appreciate your time.
| File Type | application/msword |
| File Title | DRAFT SCREENER GUIDE |
| Author | xp1bb |
| Last Modified By | Department of Treasury |
| File Modified | 2012-11-06 |
| File Created | 2012-11-06 |