online Customer Feedback Survey

Online Customer Feedback Survey

OMB Control Number: 1405-XXXX

Burden Estimate:

Expiration Date: XX-XX-XXXX

We Want to Hear From You!

Passport Services values your feedback. Please send us your feedback on your experiences with us. We use this information to improve our service. Your responses will remain anonymous, unless otherwise indicated by you below. Any identifying information provided will not be saved in our records.

For your protection, do not enter in any additional personal information or passport application details into this form. For questions about a specific case or application, please call the National Passport Information Center (NPIC) at 1-877-487-2778.

Is your feedback a compliment or a complaint?

Compliment

Complaint

Which of the following best describes the area of service your feedback pertains to?

Application Process

Passport Fees

Information Received

Customer Service

Other:

Where did you receive the service you are providing feedback for?

Acceptance Facility (Post Office, Clerk of Court, Library, etc.)

U.S. Passport Agency

By Mail

Travel.State.Gov

National Passport Information Center, (800) 487-2778

For “Acceptance Facility” or “U.S. Passport Agency” above, please specify name and/or location:

Please give us your comments below.

Would you like Passport Services to contact you if further information is needed on your feedback?

Yes (Complete fields below)

No (Omit fields below)

First Name:

Telephone:

Email:

PRA Statement

Public reporting burden for this collection of information is estimated to average xx minutes per response, including time required for searching existing data sources, gathering the necessary documentation, providing the information and/or documents required, and reviewing the final collection.  You do not have to supply this information unless this collection displays a currently valid OMB control number.  If you have comments on the accuracy of this burden estimate and/or recommendations for reducing it, please send them to:  insert Program Office address

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