Attachment 3.Net New Complaint Form Fields and Values_FINAL.xlsx

Consumer Response Intake Form

Attachment 3.Net New Complaint Form Fields and Values_FINAL.xlsx

OMB: 3170-0011

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Attachment 3- Net New Complaint Form Fields and Values
New fields and values are highlighted below
Product Sub-product (applies to all sub-products listed) Product data-driven questions Issue Sub-issues Other notes
Vehicle loan or lease Loan, lease Was the loan for a new or used vehicle? [New/Used]


Vehicle loan or lease Loan, lease
Problem at the end of the loan or lease (title, refinancing, extending a lease) Problem related to refinancing 1 of 8 sub-issues
Vehicle loan or lease Loan, lease
Problem at the end of the loan or lease (title, refinancing, extending a lease) Problem while selling or giving up the vehicle 1 of 8 sub-issues
Vehicle loan or lease Loan, lease
Problem at the end of the loan or lease (title, refinancing, extending a lease) Problem when attempting to purchase vehicle at the end of the lease 1 of 8 sub-issues
Vehicle loan or lease Loan, lease
Problem at the end of the loan or lease (title, refinancing, extending a lease) Problem extending the lease 1 of 8 sub-issues
Credit card or prepaid card Store credit card (can use only at specific store or chain of stores)



Credit card or prepaid card General-purpose prepaid card (can use anywhere; often sold at stores) Is your paycheck or government benefit payment automatically loaded onto the card (often called "direct deposit")? [yes/no]


Credit card or prepaid card Student prepaid card
(prepaid card that is linked to your school account or student ID that may be used to pay for books, meals or tuition)
Is your student loan automatically loaded onto the card? [yes/no]


Credit card or prepaid card General-purpose prepaid card, Gift card, Payroll card, Government benefit card, Student prepaid card
Trouble using the card Problem with a check written from your prepaid card account 1 of 8 sub-issues
Checking or savings account Checking account, Savings account, Debit card, Other banking product or service
Problem caused by your funds being low Non-sufficient funds and associated fees 1 of 4 sub-issues
Money transfer, virtual currency, or money service Mobile or digital wallet Are you able to store an account balance on the wallet that you can add to or draw from to use for purchases or payments? [yes/no/not sure]


Debt collection Credit card debt, Mortgage debt, Medical debt, Payday loan debt, Auto debt, Federal student loan debt, Private student loan debt, Other debt, I do not know
Took or threatened to take negative or legal action (threatened to sue, arrest you, seize property, deport you, collect exempt funds, damage your credit) Threatened or suggested your credit would be damaged 1 of 8 sub-issues
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