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pdfForm
14054 (Rev. August 2015)
Department of Treasury-Internal Revenue Service
OMB# 1545-2250
IRS WAGE & INVESTMENT CUSTOMER SATISFACTION
INJURED SPOUSE
The IRS is trying to improve the service it provides taxpayers. You can help in this important mission by answering the questions
below. This voluntary survey should take less than 7 minutes to complete. Your responses will be kept as anonymous as allowed by
law to the IRS. If you have any questions about this survey, you may call the Survey Helpline at 1-800-521-7177. Thank you for
sharing your experiences with us.
1
Regardless of whether you agree or disagree with
the final outcome, how would you rate your overall
satisfaction with the service received from the IRS
about your most recent Injured Spouse filing (Form 8379)?
Very
Dissatisfied
Dissatisfied
Neither
Satisfied nor
Dissatisfied
Satisfied
Very
Satisfied
1
2
3
4
5
Regardless of whether you agree or disagree with the final outcome of your most recent Injured Spouse filing,
please rate your satisfaction with the following:
How satisfied were you with the…
2
Very
Dissatisfied
Dissatisfied
Neither
Satisfied nor
Dissatisfied
Satisfied
Very
Satisfied
1
1
1
2
2
2
3
3
3
4
4
4
5
5
5
1
2
3
4
5
1
2
3
4
5
A. Ease of finding out about the Injured
Spouse program
B. Ease of understanding the Injured Spouse process
C. Ease of completing the Injured Spouse Form 8379
D. Length of time it took to receive your outcome
after submitting the Form 8379
E. Ease of understanding the IRS’s decision about
your Injured Spouse filing
Did Not
Complete
Form 8379
Myself
NA
`
3
What type of letter or notice prompted your most recent Injured Spouse filing? (Please mark one)
1 A letter stating the IRS used all or part of your refund to pay a tax debt.
2 A letter stating that the Bureau of Fiscal Service used all or part of your refund to pay past due child or spousal support,
federal non-tax debt (student loans), or state income tax obligation.
Other
(Please specify):
3
Did
not
receive a notice
4
4
What type of debt issue caused your most recent Injured Spouse filing? (Please mark one)
1 Federal tax debt issue
2 Non-Federal tax debt issue (e.g., child support, student loans, state income tax obligations)
3 Both (Federal tax and non-Federal tax debt)
5
6
How did you find out about the Injured Spouse program?
Yes
No
A. Letter or Notice
B. IRS Customer Service Representative
C. IRS Taxpayer Advocate Office
D. IRS website (IRS.gov)
E. Non-IRS website
F. Family/Friend/Colleague
G. Tax professional (e.g., Attorney, CPA)
H. Tax software
I. Other source (Please specify):
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
Did you visit the IRS website (IRS.gov) to get any help
or information about Injured Spouse?
Catalog Number 52758X
www.irs.gov
1 Yes
2 No
Continue to Question 7
Skip to Question 8
Form
14054 (Rev. 8-2015)
For each of the following tasks, please mark if
you used IRS.gov and mark if you found what you
were looking for.
Used
IRS.gov?
IRS.gov Tasks:
7
No
(go to next
row)
Yes
0
0
0
0
0
0
A. Get a description of the Injured Spouse process
B. Determine if I qualified for Injured Spouse assistance
C. Get the Injured Spouse Form 8379
D. Get Instructions for the Injured Spouse Form 8379
E. Get help preparing Form 8379
F. Get a status update about my Injured Spouse filing
G. Get help understanding the IRS’s final decision
about my Injured Spouse filing
H. Other (Please specify):
Found it
on IRS.gov?
If Yes,
please
continue
No
Yes
1
1
1
1
1
1
0
0
0
0
0
0
1
1
1
1
1
1
0
1
0
1
0
1
0
1
Who prepared your most recent Injured Spouse filing (Form 8379)? (Please mark one)
8
1 Yourself/Spouse
2 Tax professional (e.g., Attorney, CPA)
3 Volunteer Income Tax Assistance (VITA)
4 Friend/Relative
5 Other (Please specify):
Approximately how many weeks did you expect
the Injured Spouse process to take?
10
9
Approximately how many weeks did it take to
receive the outcome of your Injured Spouse filing?
WEEKS
11
12
13
How did you submit your most recent Injured Spouse filing (Form 8379)? (Please mark one)
1 With your original tax return
2 After your refund was applied to a debt
3 With Form 1040-X (e.g., Amended Individual Tax Return)
Did the IRS ask you to submit additional information
for your Injured Spouse filing?
1 Yes
2 No
Did you call the IRS regarding your Injured Spouse filing?
1 Yes
2 No
Did you call the IRS for ANY
of the following reasons?
14
WEEKS
Reasons for Calling:
A. For help preparing the Injured
Spouse Form 8379
B. For status update(s) about my filing
C. To submit additional information
for my filing
D. For an explanation of the IRS’s
decision about my filing
Catalog Number 52758X
Called IRS for this Reason?
If Yes,
please
continue
Continue to Question 14
Skip to Question 19
Total Number Number of
of Times You Times You
Called IRS? Spoke with
(1, 2, 3, …)
Someone
at IRS?
(1, 2, 3, …)
Were All Your Questions
Answered the 1st Time
You Spoke with Someone
at IRS?
No
Yes
1
1
0
0
1
1
0
1
0
1
0
1
0
1
No
(go to next
row)
Yes
0
0
www.irs.gov
Form
14054 (Rev. 8-2015)
If you called the IRS and the reason for your call is not listed in Questions 14A-D, please tell us why you called the IRS.
IF YOU DID NOT CALL THE IRS PLEASE SKIP TO QUESTION 19.
15
16
What was your most recent Injured Spouse call to the IRS about? (Please mark one)
1 To get help preparing Form 8379
2 To get a status update about my filing
3 To submit additional information
4 To get an explanation of the IRS’s final decision about my filing
5 Other reason
Regarding your most recent Injured Spouse call to the IRS, please rate your satisfaction with the following
aspects of telephone service:
17
A. Ease of getting through to an IRS representative
B. Representative’s willingness to help
C. Professionalism of the representative
D. Knowledge of the representative
E. Clarity of the information you received
Very
Dissatisfied
Dissatisfied
Neither
Satisfied nor
Dissatisfied
Satisfied
Very
Satisfied
1
1
1
1
1
2
2
2
2
2
3
3
3
3
3
4
4
4
4
4
5
5
5
5
5
If you answered "Very Dissatisfied" or "Dissatisfied" to any of the questions above (Questions 17A-E),
please describe why.
18
19
What was the final outcome of your Injured Spouse filing? (Please mark one)
1 Full refund (as claimed on your tax return)
2 Partial refund (Injured Spouse’s share of the refund)
3 No payment (refund was offset)
4 Case was denied
Regardless of whether you agree or disagree with the final outcome of your most recent Injured Spouse
filing, please rate your agreement with the following statements:
20
A. I had an adequate description of the Injured Spouse process
B. My experience reflected the described Injured
Spouse process
C. I had the opportunity to provide information important
to my case
D. I was treated with respect during the Injured Spouse process
E. The outcome was reasonable given what I provided
to the IRS
Catalog Number 52758X
www.irs.gov
Strongly
Disagree
Disagree
Neither
Agree nor
Disagree
Agree
Strongly
Agree
1
2
3
4
5
1
2
3
4
5
1
1
2
2
3
3
4
4
5
5
1
2
3
4
5
Form
14054 (Rev. 8-2015)
21
Overall, how well did the IRS meet your expectations while
handling your Injured Spouse filing?
Much
Worse Than
Expected
1
Worse Than As Expected
Expected
2
Better Than
Expected
Much
Better Than
Expected
4
5
3
If you answered "Much Worse Than Expected" or "Worse Than Expected" above (Question 21), please describe why.
22
Occasionally, we conduct additional in-depth IRS-related research. Research participants may receive a small monetary incentive to
participate depending on the research. If you are interested in participating in future research, please provide us with your telephone
number and your email address (if available). This information will not be shared with the IRS and will be used only for the purpose of
survey research.
PHONE NUMBER
EMAIL ADDRESS
Thank you for completing the survey.
Please return the questionnaire to P.O. Box 42048, Arlington, VA 22204-9048 USA.
Paperwork Reduction Act Notice. The Paperwork Reduction Act requires that the IRS provide an OMB control number relating to all public information requests along with
the address where you can send comments regarding the survey. The OMB number for this survey is 1545-2250. If you have any comments regarding this survey, please write
to: IRS, Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, Room 6526, 1111 Constitution Avenue, NW, Washington, DC 20224.
Privacy Statement:
The authority requesting the information is 5 USC 301. The primary purpose of asking for the information is to determine steps IRS can take to
improve our service to you. The information may be disclosed as authorized by the routine uses published for the Privacy Act System of
Records entitled, Treas/IRS 00.001 Correspondence Files, including Stakeholder Partnership File, and Correspondence Control Files, as
published in the Federal Register: December 10, 2011 (Volume 66, Number 237) [Notices] pages 63785-6. Providing the information is
voluntary. Not answering some or all of the questions will not affect you.
Catalog Number 52758X
www.irs.gov
Form
14054 (Rev. 8-2015)
| File Type | application/pdf |
| File Modified | 2018-05-02 |
| File Created | 2015-11-23 |