Consumer Response - Small Business Intake

Screener
Consumer Response – Small Business Intake
Participants
•

Small business owners
a. Revenue of at least 100K
b. No self-employed/no employee participants (minimum 10 employees)
c. Small business defined as less than 500 employees
d. Participants must be located outside the Washington D.C. area
e. Participants must have a banking relationship (such as having a business checking
account)
User Group

Total number of participants

Number of
participants
9

Small-business owners (no special ownership
designation)

3

Minority-owned small-business owners

3

Women-owned small-business owners

3

Recruitment Plan
•
•
•
•

A panel provider will host the participation opportunity on their website.
Panel members will have the option to complete a web-based screener to determine if they
qualify for the study.
The FMG recruitment team will contact qualified participants by phone and administer the
phone-based screener to ensure they should be selected for participation.
Participants will be sent $75 via PayPal after their participation in the interview.

Web-Based Screener
Initial Project Description: Small business owners requested to help improve a Government website
Introduction: Fors Marsh Group is conducting remote one-on-one interviews with small-business
owners. Participants will be asked to complete tasks on a website and provide insight based on their
experience as a small-business owner.
Incentive: $75 for 1 hour
Q1. Fors Marsh Group is conducting interviews on behalf of the Consumer Financial Protection
Bureau to help improve a website used to submit complaints about financial institutions. Please click
on the check boxes to indicate that you have reviewed the following information:
Privacy Act Statement
5 U.S.C. 552(a)(e)(3)
The information you provide through your responses to Fors Marsh Group will assist the
survey sponsor, the Consumer Financial Protection Bureau (“CFPB”), in evaluating a form
that consumers can complete to file a complaint about a financial institution.
The CFPB will not obtain or access any directly identifying information from Fors Marsh about
study participants. The agency will only obtain and access de-identified results and
aggregated analyses of those results.
Information collected on behalf of the Bureau by Fors Marsh Group will be treated in
accordance with the System of Records Notice (“SORN”), CFPB.005 – CFPB Consumer
Response System, 79 FR 21440. Direct identifying information will only be used by Fors
Marsh Group to facilitate the study and will be kept private except as required by law.
This collection of information is authorized by Pub. L. 111-203, Title X, Sections 1011, 1012,
1013(b)(3), 1021, 1034, codified at 12 U.S.C. 5491, 5492, 5493(b)(3), 5511, 5534..
Paperwork Reduction Act
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor,
and a person is not required to, respond to a collection of information unless it displays a
valid OMB control number. The OMB control number for this collection is 3170-0042. It
expires on 05/31/2018. The time required to complete this information collection is
estimated to average approximately 5 minutes per response. Responding to this collection of
information is voluntary. Comments regarding this collection of information, including the
estimated response time, suggestions for improving the usefulness of the information, or
suggestions for reducing the burden to respond to this collection should be submitted to
Bureau at the Consumer Financial Protection Bureau (Attention: PRA Office), 1700 G Street
NW, Washington, DC 20552, or by email to [email protected] .

Participation in this survey is voluntary, you are not required to participate or share any
identifying information with Fors Marsh Group, including name and email address, and you
may withdraw participation at any time. However, if you do not include the requested
information, you may not participate in the study.
Q1. Are you a small-business owner?
o
o

Yes
No [Terminate]

Q2. How many employees do you have?
o
o
o
o
o
o

10 employees or less [Terminate]
11–50 employees
51–100 employees
101–250 employees
251–500 employees
More than 500 employees

Q3. What is the estimated annual revenue for your business?
o
o
o
o
o

Less than $100K [Terminate]
$100K to less than $1M
$1M to less than $5M
$5M to less than $10M
$10M or more

Q4. Please describe the products or services that your business provides: [Text box]
Q5. What is the city and state where your business is located? [Text box]
Q6. Is your small business classified as any of the following?
Women-owned business
Minority-owned business
Veteran-owned business
Native American owned business
Small disadvantaged business
None of the above
Q7. Which of the following financial services does your business use?
Business checking account
Business credit card
Merchant services
Business loan
Business line of credit
None of the above [Terminate]

Q8. Have you had any issues with any financial institution’s services in the past year? If yes, please
take a few sentences to describe: [Large Text Box]
Q9.

First name: [Text box]

Last name: [Text box]

Q10.

Email [Text box]

Q11.

Phone number: [Text box]

Q12.

Age:
o 18–25 years old
o 25–34 years old
o 35–44 years old
o 45–64 years old
o 65+ years old

Q13.

What is your gender?
o Male
o Female

Q14. Are you of Hispanic, Latino, or Spanish origin?
o No, not of Hispanic, Latino, or Spanish origin
o Yes, of Hispanic, Latino, or Spanish origin
Q15. Please select all of the following that best describe your race:
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Q16.

What is the highest educational degree that you have earned?
o Less than high school degree or equivalent
o High school graduate (grade 12, diploma, or GED)
o Trade school certificate
o Some college courses completed
o Graduated with a 2-year degree (Associate)
o Graduated with a 4-year degree (Bachelor’s)
o Some graduate school courses completed
o Graduated with a post-graduate degree

Thank you for completing this survey. We will be in contact if you qualify and are selected for this
study. If you have any questions, please contact Fors Marsh Group at [email protected] or
call us at 571-858-3817. You can also visit our website at www.forsmarshgroup.com.

Phone-Based Screener (for those who qualify based on web-based screener)
Hello ______. Thank you for your interest in participating in a user experience study with Fors Marsh
Group. My name is ________ and I wanted to follow up regarding a web-based survey that you
completed recently for upcoming interviews with small-business owners. I wanted to ask a couple
more questions and see if we can schedule you. Your participation is completely voluntary. Do you
have a few minutes?
Q1. Could you tell me about the responsibilities you have as the owner of your business?
Q2. Could you talk about the products or services that your business provides? [Open ended.
Terminate if responses are inconsistent with web-based screener]
Q3. Could you confirm the financial services that your small business uses to operate? //List
responses from web screener//
Invitation:
We would like to invite you to participate in an interview. During the interviews, participants will be
asked to complete tasks on a website and provide insight based on their experience as a smallbusiness owner. The entire interview should last an hour, and you will be paid $75 via PayPal after
the interview. Would you like to participate in this study?
Reconfirm participant’s email address.

Terminate message: both for web and phone screener
We are sorry but based on your responses you unfortunately do not qualify for this study. Thank you
for your interest in participating.