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[IRS DEPARTMENT LETTERHEAD]
[DATE]
Name1
Name2
Name3
Name4
Address
City, State, Zip
Dear IRS Employee Plan Determination Letter Request Customer:
I need your help with an important initiative we are undertaking to improve our service to America’s
taxpayers.
IRS recently made a determination on the qualification of your organization’s employee pension plan.
In a few days, you will receive a survey asking your opinions about your experience and the service
you received from IRS. If you are not the person who had the most contact with the IRS on this matter,
please direct the survey to the person who did.
This brief survey should take less than 8 minutes to complete. Your answers will be combined with
others to give us an evaluation of customer satisfaction with IRS service.
An independent research company, ICF International, will administer the survey and will keep your
responses anonymous to the IRS. No identifying information will be associated with your responses.
Your responses will be compiled with those of other recent customers and reported only in the
aggregate to the IRS.
We are committed to improving service to every customer. Please help me in this effort by completing
and returning the survey as soon as possible.
Sincerely,
Sarah Hall Ingram
Commissioner
Tax Exempt and Government Entities Division
L1_12184-A_T
ICF International/Scantron
IRS Customer Survey
P.O. Box 64529
St. Paul, MN 55164-0529
[DATE]
Name1
Name2
Name3
Name4
Address
City, State, Zip
RE: FIRM NAME
PLAN NAME
PLAN NUMBER
Dear JOHN Q & MARY Q SAMPLE:
A few days ago you received a letter from IRS, Tax-Exempt and Government Entities Commissioner
Sarah Ingram asking for your help with an important research project. The Internal Revenue Service (IRS)
is committed to improving its performance and service to the American public. As part of this process, we
are administering a nationwide survey to gather reliable information from those who have had contact with
IRS employees and services.
Your name was selected through a scientific random sampling process to receive this survey because you
recently handled an Employee Plan Determination Letter Request for your client. We want to know your
opinions regarding that experience and the service you received from IRS. Your responses are critical
to the accuracy of this evaluation of the IRS’s service. If another person was primarily responsible for
dealing with the IRS on this matter, please pass this survey on to them and encourage them to respond.
Your participation is voluntary. An independent research company will keep your responses anonymous
to the IRS. Your responses will be grouped with others, so that no individual reply can be traced back to a
person or case number. No identifying information will be associated with your responses.
This brief survey should take less than 8 minutes to complete. Use the postage-paid reply envelope
to return your completed survey. If you have any questions or concerns, please feel free to call ICF
International toll free at 1-866-287-5762 or e-mail us at [email protected].
To verify the authenticity of this survey, please visit IRS.gov and enter the search term ‘customer surveys.’
The IRS Customer Satisfaction Survey page contains a list of valid, current and unexpired, IRS surveys
and as of this issuance should provide a reference to TE/GE Employee Plan Determinations.
Thank you in advance for your cooperation. Your honest opinions will help bring about improvements in
service for all employee plans.
Sincerely,
Sherri Settle
Project Director
ICF International
L2_12184-A_ POA
OMB# 1545-1432
Internal Revenue Service (IRS) Customer Satisfaction Survey
Employee Plan Determination Letter Request
You can help the IRS improve its service to the public by answering the questions below. This voluntary survey takes less than
8 minutes to complete.
Your responses will be kept anonymous to the IRS. Only aggregate information will be provided to the IRS.
The following questions ask your opinion regarding your most recent IRS employee plan determination request. Regardless
of whether you agree or disagree with the final outcome, please mark the appropriate box on the scale (where 1 means “Very
Dissatisfied” and 7 means “Very Satisfied”) or next to the response that best applies to you.
Overall Satisfaction
Very
Satisfied
Very
Dissatisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
1.
How would you rate your overall satisfaction with the way your case was
handled by the IRS, regardless of whether you agree or disagree with
the final outcome?
2.
Overall, how satisfied are you with the length of the process, from
submission of your application through final determination?
3.
Overall, how satisfied are you with how well the IRS communicated with
you throughout the process (whether in writing or by telephone)?
Application
Very
Satisfied
Very
Dissatisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
4.
The ease of locating the correct application form and instructions?
5.
The ease of understanding the application form and instructions?
6.
The ease of completing the application form?
7.
The amount of time you spent completing your application?
Acknowledgement Letter (Confirming Receipt of Application)
Very
Dissatisfied
How satisfied are you with…
How quickly you received your acknowledgment letter?
9.
How clearly the acknowledgement letter communicated the expected
timeframe until the IRS would contact you?
10.
Did the IRS contact you within the timeframe stated in the acknowledgement letter?
11.
Don’t Know
Not Applicable
1 2 3 4 5 6 7
8.
Very
Satisfied
Yes, I received a letter or telephone call within the stated timeframe.
No, I did not receive a letter or telephone call within the stated timeframe.
I initiated contact before the stated timeframe elapsed.
How satisfied are you with the amount of time it took for the IRS to
contact you (following your acknowledgement letter)?
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Please continue on next page
Department of the Treasury-Internal Revenue Service
12.
Were you contacted by the IRS to provide additional information?
Yes No
[If your response is No, please skip to Question 27.]
Additional Information Request (After Receipt of Acknowledgement Letter)
Very
Satisfied
Very
Dissatisfied
13.
Overall, how satisfied are you with the IRS agent/specialist assigned to
your case?
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
14.
The courtesy of the IRS agent/specialist?
15.
The knowledge of the IRS agent/specialist?
16.
How well the IRS agent/specialist listened to your concerns?
17.
How thoroughly the IRS agent/specialist answered your questions?
18.
Communications about the status of your determination?
19.
The consideration given to the information you presented in the original
application or submission?
20.
The description of the additional information the IRS needed to complete
your determination?
21.
The explanation of why additional information was requested?
22.
The time given you to respond to additional IRS request(s)?
23.
The amount of time you spent responding to IRS requests for additional
information?
24.
The timeliness of the IRS agent/specialist in responding to your
inquiries?
25.
How many times were you contacted by the IRS agent/specialist to
obtain additional information?
26.
None
One
Two
Three or more
If you answered one or more to Question 25 above, which method of
information exchange was the most beneficial when the IRS agent/
specialist contacted you? (Check all that apply)
Telephone
Fax
Mail
Final Determination
Very
Dissatisfied
Very
Satisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
27.
The ease of understanding the determination letter you received?
Other Information
28.
What are the estimated total assets of the plan for which this determination was sought?
Less than $100,000
$100,000 to $499,999
$1,000,000 to $4,999,999
$5,000,000 or more
$500,000 to $999,999
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Please continue on next page
Department of the Treasury-Internal Revenue Service
29.
For this determination, were you…
An employee/officer of the organization? [Skip to Question 31]
A designated third-party representative/power of attorney (POA)?
ANSWER ONLY IF YOU ARE A DESIGNATED THIRD-PARTY REPRESENTATIVE/POWER OF ATTORNEY (POA)
Very
Inconsistent
Very
Consistent
1 2 3 4 5 6 7
30.
If you are a designated third-party representative/power of attorney, how
consistent was the IRS in its handling of this application compared with other
applications you have completed in the past year?
31.
Did you visit the IRS website (www.irs.gov/ep) for assistance or information during the determination process?
Don’t Know
Not Applicable
Yes
No
Comments
32.
If you have any suggestions for how Employee Plans can improve its determination process, or any other comments,
please provide them below.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
If you have any questions about this survey, please contact the survey processing center at 1-866-287-5762 or
[email protected].
!
If you have been unable to resolve any specific problems with your tax matter through the normal IRS channels,
or now face a significant hardship due to the application of the tax law, we encourage you to contact the Taxpayer
Advocate Service at 1-877-777-4778.
Thank you for completing the survey.
Paperwork Reduction Act Notice
The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control
Number for this study is 1545-1432. Also, if you have any comments regarding the time estimates associated with this study or suggestions
on making this process simpler, please write to: Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP,
1111 Constitution Ave. NW, Washington, DC 20224.
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Department of the Treasury-Internal Revenue Service
ICF International/Scantron
IRS Customer Survey
P.O. Box 64529
St. Paul, MN 55164-0529
Do We Have Your Input Yet?
Recently, you received a survey asking your opinions about the service
you received in a recent interaction with the IRS. If you have already
completed and returned the survey, please accept our sincere thanks.
If not, please take a few minutes to complete and return it today. We
want to be sure we have your opinions and suggestions for improving
the IRS’s service to the public.
If you did not receive the survey, or it has been misplaced, please contact
us at 1-866-287-5762 or [email protected].
Sherri Settle
Project Director
ICF International
L3_12184-A
ICF International/Scantron
IRS Customer Survey
P.O. Box 64529
St. Paul, MN 55164-0529
[DATE]
Name1
Name2
Name3
Name4
Address
City, State, Zip
RE: FIRM NAME
PLAN NAME
PLAN NUMBER
Dear JOHN Q & MARY Q SAMPLE:
Recently you received a survey requesting your views about the IRS Employee Plan Determination Letter
Request process. So far, we have not received your completed survey. If you have not already done so,
please take a few minutes to provide your response. If another person was primarily responsible for
dealing with the IRS on this matter, please pass this survey on to them and encourage them to respond.
As described in our previous communication, we are administering a nationwide survey among people
who have interacted with the IRS. We want to know your opinions regarding the service you received in a
recent Employee Plan Determination Letter Request that you handled for your client. Your responses are
critical to the accuracy of this evaluation of the IRS’s service.
Your name was selected through a scientific random sampling process to receive this survey. Your
participation is voluntary. An independent research company will keep your responses anonymous to
the IRS. Your responses will be grouped with others, so that no individual reply can be traced back to a
person or case number. No identifying information will be associated with your responses.
The survey takes less than 8 minutes to complete. Use the postage-paid reply envelope to return your
completed survey. If you have any questions or concerns, please feel free to call ICF International at
1-866-287-5762 or e-mail us at [email protected].
To verify the authenticity of this survey, please visit IRS.gov and enter the search term ‘customer surveys.’
The IRS Customer Satisfaction Survey page contains a list of valid, current and unexpired, IRS surveys
and as of this issuance should provide a reference to TE/GE Employee Plan Determinations.
The IRS is committed to improving its performance and service to the American public. A vital step in
this process is to gather reliable information from those who have had contact with IRS employees and
services. Your honest opinions will help bring about these improvements.
Thank you in advance for your cooperation.
Sincerely,
Sherri Settle
Project Director
ICF International
L4_12184-A_POA
OMB# 1545-1432
Internal Revenue Service (IRS) Customer Satisfaction Survey
Employee Plan Determination Letter Request
You can help the IRS improve its service to the public by answering the questions below. This voluntary survey takes less than
8 minutes to complete.
Your responses will be kept anonymous to the IRS. Only aggregate information will be provided to the IRS.
The following questions ask your opinion regarding your most recent IRS employee plan determination request. Regardless
of whether you agree or disagree with the final outcome, please mark the appropriate box on the scale (where 1 means “Very
Dissatisfied” and 7 means “Very Satisfied”) or next to the response that best applies to you.
Overall Satisfaction
Very
Satisfied
Very
Dissatisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
1.
How would you rate your overall satisfaction with the way your case was
handled by the IRS, regardless of whether you agree or disagree with
the final outcome?
2.
Overall, how satisfied are you with the length of the process, from
submission of your application through final determination?
3.
Overall, how satisfied are you with how well the IRS communicated with
you throughout the process (whether in writing or by telephone)?
Application
Very
Satisfied
Very
Dissatisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
4.
The ease of locating the correct application form and instructions?
5.
The ease of understanding the application form and instructions?
6.
The ease of completing the application form?
7.
The amount of time you spent completing your application?
Acknowledgement Letter (Confirming Receipt of Application)
Very
Dissatisfied
How satisfied are you with…
How quickly you received your acknowledgment letter?
9.
How clearly the acknowledgement letter communicated the expected
timeframe until the IRS would contact you?
10.
Did the IRS contact you within the timeframe stated in the acknowledgement letter?
11.
Don’t Know
Not Applicable
1 2 3 4 5 6 7
8.
Very
Satisfied
Yes, I received a letter or telephone call within the stated timeframe.
No, I did not receive a letter or telephone call within the stated timeframe.
I initiated contact before the stated timeframe elapsed.
How satisfied are you with the amount of time it took for the IRS to
contact you (following your acknowledgement letter)?
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Please continue on next page
Department of the Treasury-Internal Revenue Service
12.
Were you contacted by the IRS to provide additional information?
Yes No
[If your response is No, please skip to Question 27.]
Additional Information Request (After Receipt of Acknowledgement Letter)
Very
Satisfied
Very
Dissatisfied
13.
Overall, how satisfied are you with the IRS agent/specialist assigned to
your case?
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
14.
The courtesy of the IRS agent/specialist?
15.
The knowledge of the IRS agent/specialist?
16.
How well the IRS agent/specialist listened to your concerns?
17.
How thoroughly the IRS agent/specialist answered your questions?
18.
Communications about the status of your determination?
19.
The consideration given to the information you presented in the original
application or submission?
20.
The description of the additional information the IRS needed to complete
your determination?
21.
The explanation of why additional information was requested?
22.
The time given you to respond to additional IRS request(s)?
23.
The amount of time you spent responding to IRS requests for additional
information?
24.
The timeliness of the IRS agent/specialist in responding to your
inquiries?
25.
How many times were you contacted by the IRS agent/specialist to
obtain additional information?
26.
None
One
Two
Three or more
If you answered one or more to Question 25 above, which method of
information exchange was the most beneficial when the IRS agent/
specialist contacted you? (Check all that apply)
Telephone
Fax
Mail
Final Determination
Very
Dissatisfied
Very
Satisfied
Don’t Know
Not Applicable
1 2 3 4 5 6 7
How satisfied are you with…
27.
The ease of understanding the determination letter you received?
Other Information
28.
What are the estimated total assets of the plan for which this determination was sought?
Less than $100,000
$100,000 to $499,999
$1,000,000 to $4,999,999
$5,000,000 or more
$500,000 to $999,999
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Please continue on next page
Department of the Treasury-Internal Revenue Service
29.
For this determination, were you…
An employee/officer of the organization? [Skip to Question 31]
A designated third-party representative/power of attorney (POA)?
ANSWER ONLY IF YOU ARE A DESIGNATED THIRD-PARTY REPRESENTATIVE/POWER OF ATTORNEY (POA)
Very
Inconsistent
Very
Consistent
1 2 3 4 5 6 7
30.
If you are a designated third-party representative/power of attorney, how
consistent was the IRS in its handling of this application compared with other
applications you have completed in the past year?
31.
Did you visit the IRS website (www.irs.gov/ep) for assistance or information during the determination process?
Don’t Know
Not Applicable
Yes
No
Comments
32.
If you have any suggestions for how Employee Plans can improve its determination process, or any other comments,
please provide them below.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
If you have any questions about this survey, please contact the survey processing center at 1-866-287-5762 or
[email protected].
!
If you have been unable to resolve any specific problems with your tax matter through the normal IRS channels,
or now face a significant hardship due to the application of the tax law, we encourage you to contact the Taxpayer
Advocate Service at 1-877-777-4778.
Thank you for completing the survey.
Paperwork Reduction Act Notice
The Paperwork Reduction Act requires that the IRS display an OMB control number on all public information requests. The OMB Control
Number for this study is 1545-1432. Also, if you have any comments regarding the time estimates associated with this study or suggestions
on making this process simpler, please write to: Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP,
1111 Constitution Ave. NW, Washington, DC 20224.
Form 12184-A (Rev. 8-2011)
Cat. No. 26977G
Department of the Treasury-Internal Revenue Service
| File Type | application/pdf |
| File Modified | 2011-09-21 |
| File Created | 2011-09-21 |