Consumer Response Intake Form

Product

Sub-product (applies to
all sub-products listed)

Vehicle loan or
lease
Vehicle loan or
lease

Loan, lease

Vehicle loan or
lease

Loan, lease

Vehicle loan or
lease

Loan, lease

Vehicle loan or
lease

Loan, lease

Credit card or
prepaid card

Store credit card (can use only
at specific store or chain of
stores)
General-purpose prepaid card
(can use anywhere; often sold at
stores)

Credit card or
prepaid card

Credit card or
prepaid card

Credit card or
prepaid card

Checking or
savings account

Loan, lease

Student prepaid card
(prepaid card that is linked to
your school account or student
ID that may be used to pay for
books, meals or tuition)
General-purpose prepaid card,
Gift card, Payroll card,
Government benefit card,
Student prepaid card
Checking account, Savings
account, Debit card, Other
banking product or service

Money transfer,
Mobile or digital wallet
virtual currency, or
money service

Debt collection

Credit card debt, Mortgage debt,
Medical debt, Payday loan debt,
Auto debt, Federal student loan
debt, Private student loan debt,
Other debt, I do not know

(product data driven
questions)

Issue

Was the loan for a new or used
vehicle? [New/Used]
Problem at the end of the loan or
lease (title, refinancing, extending a
lease)
Problem at the end of the loan or
lease (title, refinancing, extending a
lease)
Problem at the end of the loan or
lease (title, refinancing, extending a
lease)
Problem at the end of the loan or
lease (title, refinancing, extending a
lease)

Is your paycheck or government
benefit payment automatically
loaded onto the card (often called
"direct deposit)? [yes/no]
Is your student loan automatically
loaded onto the card? [yes/no]

Trouble using the card

Problem caused by your funds being
low

Are you able to store an account
balance on the wallet that you can
add to or draw from to use for
purchases or payments?
[yes/no/not sure]
Took or threatened to take negative
or legal action (threatened to sue,
arrest you, seize property, deport
you, collect exempt funds, damage
your credit)

Sub-issues

Problem related to refinancing

Problem while selling or giving up
the vehicle
Problem when attempting to
purchase vehicle at the end of the
lease
Problem extending the lease

Problem with a check written from
your prepaid card account

Non-sufficient funds and
associated fees

(issue data-driven
questions)

Threatened or suggested your
credit would be damaged

1 of 8 sub-issues

1 of 8 sub-issues

1 of 8 sub-issues

1 of 8 sub-issues

1 of 8 sub-issues

1 of 4 sub-issues

1 of 8 sub-issues