INV 10 Interview Survey Form

National
Background
Investigations
Bureau

www.opm.gov

National Background
Investigations
Bureau

Recruit, Retain and Honor a World-Class Workforce to Serve the American People

www.nbib.opm.gov

1

IN PERSON

Were you interviewed in person or over the phone?
2a

BY PHONE

(Proceed to Question 2a) (Proceed to Question 2b)

For interviews conducted in person:
Was the Investigator dressed professionally and well groomed?
Did the Investigator show you credentials and introduce himself/herself
as a Special Agent or Investigator with the U.S. Office of Personnel Management?
Were you interviewed alone (no third party present)?
If “NO,” please explain_________________________________________________
Were you interviewed in a private setting or private, enclosed space?
If “NO,” please explain_________________________________________________

YES

NO

YES
YES

NO
NO

YES

NO

2b

For interviews conducted by phone:
Did the Investigator introduce himself/herself as a Special Agent or Investigator
with the U.S. Office of Personnel Management?
YES
NO
Were you offered to be interviewed in person?
YES
NO
Please explain why the interview was conducted by telephone:_______________________________________
3

4

5

Was the Investigator polite and professional?

YES

NO

Did the Investigator explain that the interview was for employment or security clearance purposes?

YES

NO

Were questions presented in a clear manner so that they could be understood easily?

YES

NO

6

included issues
or concerns
If you told the Investigator about concerns regarding the person being investigated, briefly identify those concerns below:
(For example-criminal conduct, illegal drug use, alcohol abuse, violent behavior, foreign travel)
CONCERNS:
The information you provided about the person being investigated (check one)...

was favorable

7

Please provide any additional comments or concerns you have about the investigator and/or the interview, and
indicate if you require additional contact from an OPM representative.

8

Signature:______________________________________________ Date:_____________________________
Please provide your contact information:
Daytime telephone number: (

)___________-________________

Email Address:_______________________________________________
OMB Control Number: 3206-0106